Open Access

Efficacy and survival outcomes of alectinib vs. crizotinib in ALK‑positive NSCLC patients with CNS metastases: A retrospective study

  • Authors:
    • Qing Liu
    • Ying Fu
    • Jun Guo
    • Chunqiu Fu
    • Ning Tang
    • Chufeng Zhang
    • Xiao Han
    • Zhehai Wang
  • View Affiliations

  • Published online on: March 22, 2024     https://doi.org/10.3892/ol.2024.14357
  • Article Number: 224
  • Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) have transformed the treatment paradigm for patients with ALK‑positive non‑small cell lung cancer (NSCLC). Yet the differential efficacy between alectinib and crizotinib in treating patients with NSCLC and central nervous system (CNS) metastases has been insufficiently studied. A retrospective analysis was conducted of clinical outcomes of patients with ALK‑positive NSCLC and CNS metastases treated at the Shandong Cancer Centre. Based on their initial ALK‑TKI treatment, patients were categorised into either the crizotinib group or the alectinib group. Efficacy, progression‑free survival (PFS), intracranial PFS and overall survival (OS) were evaluated. A total of 46 eligible patients were enrolled in the present study: 33 patients received crizotinib and 13 patients received alectinib. The median OS of the entire group was 66.8 months (95% CI: 48.5‑85.1). Compared with the patients in the crizotinib group, the patients in the alectinib group showed a significant improvement in both median (m)PFS (27.5 vs. 9.5 months; P=0.003) and intracranial mPFS (36.0 vs. 10.8 months; P<0.001). However, there was no significant difference in OS between the alectinib and crizotinib groups (not reached vs. 58.7 months; P=0.149). Furthermore, there were no significant differences between patients receiving TKI combined with radiotherapy (RT) vs. TKI alone with respect to mPFS (11.0 vs. 11.7 months, P=0.863) as well as intracranial mPFS (12.5 vs. 16.9 months, P=0.721). In the present study, alectinib exhibited superior efficacy to crizotinib for treating patients with ALK‑positive NSCLC and CNS metastases, especially in terms of delaying disease progression and preventing CNS recurrence. Moreover, the results demonstrated that it might be beneficial to delay local RT for patients with ALK‑positive NSCL and CNS metastases.
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May-2024
Volume 27 Issue 5

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Spandidos Publications style
Liu Q, Fu Y, Guo J, Fu C, Tang N, Zhang C, Han X and Wang Z: Efficacy and survival outcomes of alectinib vs. crizotinib in ALK‑positive NSCLC patients with CNS metastases: A retrospective study. Oncol Lett 27: 224, 2024.
APA
Liu, Q., Fu, Y., Guo, J., Fu, C., Tang, N., Zhang, C. ... Wang, Z. (2024). Efficacy and survival outcomes of alectinib vs. crizotinib in ALK‑positive NSCLC patients with CNS metastases: A retrospective study. Oncology Letters, 27, 224. https://doi.org/10.3892/ol.2024.14357
MLA
Liu, Q., Fu, Y., Guo, J., Fu, C., Tang, N., Zhang, C., Han, X., Wang, Z."Efficacy and survival outcomes of alectinib vs. crizotinib in ALK‑positive NSCLC patients with CNS metastases: A retrospective study". Oncology Letters 27.5 (2024): 224.
Chicago
Liu, Q., Fu, Y., Guo, J., Fu, C., Tang, N., Zhang, C., Han, X., Wang, Z."Efficacy and survival outcomes of alectinib vs. crizotinib in ALK‑positive NSCLC patients with CNS metastases: A retrospective study". Oncology Letters 27, no. 5 (2024): 224. https://doi.org/10.3892/ol.2024.14357