scholarly journals Efficacy of Alectinib in ALK-Positive Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with Crizotinib

Author(s):  
zhiqin lu ◽  
Yuanyuan Liang ◽  
Xia Wang ◽  
Zhimin Zeng ◽  
Congying Zhong ◽  
...  

Abstract PurposeLeptomeningeal metastases is a fatal complication of advanced non-small cell lung cancer (NSCLC). This study aimed to assess the clinical efficacy of alectinib in ALK-positive NSCLC with LM patients previously treated with crizotinib.MethodsRetrospective study of NSCLC patients with alectinib-treated ALK- positive NSCLC and LM.ResultsFourteen patients (mean age, 55 years; 50% women) with adenocarcinoma NSCLC were included in the study. Before starting alectinib, all patients were treated with crizotinib. When LM was diagnosed, all patients had clinical symptoms. Sixteen (50%) patients had a performance status>2. Of 14 total patients, 85.7% (12/14) of the patients had a clinical and radiological responses. From the start of alectinib, median OS and PFS were 17.4 (95% CI, 8.9–25.9) and 11.6 months (95% CI: 8.4–14.8), respectively, one-year survival rate was 57.1%.ConclusionAlectinib had significant efficacy against NSCLC with LM, this efficacy was rapid in several patients, even some with poor performance status. Alectinib might be a suitable option for specific patient populations with advanced ALK-positive NSCLC with LM.

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1995
Author(s):  
Nagio Takigawa ◽  
Nobuaki Ochi ◽  
Nozomu Nakagawa ◽  
Yasunari Nagasaki ◽  
Masataka Taoka ◽  
...  

Lung cancer patients ≥75 years represent nearly 40% of all lung cancer patients and continue to increase. If elderly patients have a good performance status and adequate organ function, they can be treated the same as non-elderly patients. However, few comparative studies limited to elderly patients (≥75 years) have been conducted. We review the evidence on using immune check inhibitors for the treatment of elderly patients (≥75 years old) with advanced non-small cell lung cancer. Prospective randomized or non-randomized, retrospective, registrational, insurance-based, and community-based studies have shown that elderly (≥75 years) and non-elderly patients are similarly treated with immune check inhibitors effectively and safely. However, such analyses have not shown that immune check inhibitors are significantly more effective than chemotherapy alone. In addition, patient selection might be critically performed to administer immune check inhibitors in the elderly because they are more likely to have a poor performance status with comorbidities, which lead to little benefit, even in non-elderly patients. There is a need for more evidence showing the benefit of immune check inhibitors in non-small cell lung cancer patients ≥75 years.


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