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Arschang Valipour



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    P2.13 - Targeted Therapy (Not CME Accredited Session) (ID 962)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.13-03 - Real-Life Experience with Brigatinib in Pretreated EML4-ALK Translocated NSCLC Patients (ID 13703)

      16:45 - 18:00  |  Author(s): Arschang Valipour

      • Abstract
      • Slides

      Background

      Patients with lung cancer, who show EML4-ALK translocation are routinely treated with ALK inhibitors (ALKi) as Alectinib, Ceritinib or Crizotinib, but develop resistance over time in the majority of cases. Brigatinib, a new next-generation ALKi, is FDA approved in crizotinib-refractory ALK-positive NSCLC. The role of Brigatinib after Ceritinib or Alectinib failure is unknown in clinical practice. We report about our experience with Brigatinib in EML4-ALK translocated NSCLC patients, who became resistant to Alectinib, Ceritinib or Crizotinib.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We treated 35 EML4-ALK translocated NSCLC patients with Brigatinib. Patient characteristics including sex, age, race, presence/ absence of brain metastases and smoking history of ALK+ NSCLC patients were collected. All data were obtained from Otto-Wagner hospital from August 2015 until April 2018.

      Before receiving Brigatinib, the patients were either only treated with Crizotinib (n = 15), with Crizotinib and then Ceritinib (n = 12), with Alectinib (n=1), with Crizotinib and then Alectinib (n=3), with Crizotinib, then Ceritinib and then Alectinib (n=1) or with Ceritinib and Alectinib (n=3).

      All patients were treated with daily dose of 180 mg oral Brigatinib after a 7- day lead- in at 90 mg.

      4c3880bb027f159e801041b1021e88e8 Result

      27 patients were women and 8 men. 3 patients were smokers ( 8,5%), 9 were former smokers ( 25,7 %) and 23 were never smokers (65,7%). 13 patients had initial brain metastases (31%). 34 of the treated patients are Caucasians and 1 is Asian. 3 of the 35 showed a complete response (9%), 25 a partial response (76%) and 5 a disease progression (15%), 2 were not evaluable. 7 of the 13 patients with brain metastases responded to Brigatinib (54%). The median PFS (progression free survival) was 7.5 months (range 1-21) and treatment of 21 patients is still ongoing. Of the 15 patients, who received only Crizotinib before Brigatinib, 2 patients were complete responders, 12 were partial responders and 1 had disease progression. Of the 12 patients, who received Crizotinib followed by Ceritinib, 1 patient had a complete response, 9 partial response and 2 disease progression. All other patients demonstrated a partial response except two, who had disease progression with Brigatinib following Ceritinib/ Alectinib treatment. Brigatinib was well tolerated overall.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Brigatinib was highly effective in these pretreated EML4-ALK translocated NSCLC patients in clinical practice.

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