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Kanae Togo

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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.01-30 - Treatment Sequencing in Patients With Anaplastic Lymphoma Kinase (ALK)-Positive Non-Small Cell Lung Cancer (NSCLC) in Japan (ID 12786)

      12:00 - 13:30  |  Author(s): Kanae Togo

      • Abstract
      • Slides


      Limited data are available on real-world treatment patterns and outcomes of ALK inhibitors used sequentially. Access to a large medical records database and availability of multiple ALK inhibitors in Japan, the first country to approve alectinib in 2014, presents a unique opportunity to evaluate real-world treatment sequencing and outcomes in ALK-positive NSCLC patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This descriptive, retrospective observational study used inpatient/outpatient medical and prescription records, claims and diagnoses from the Japan Medical Data Vision (MDV) Database. Included patients had confirmed diagnosis of lung cancer, an ALK test and first prescription order for an ALK inhibitor (prescription date = index date) on or before March 31, 2017. Descriptive analyses included demographics, baseline characteristics, treatment patterns including ALK inhibitor sequences, non-ALK inhibitor treatments received, and treatment duration.

      4c3880bb027f159e801041b1021e88e8 Result

      Overall, 378 patients (mean age 61 years; 53% female; 48% no history of smoking) met inclusion criteria. Baseline characteristics were similar among mutually exclusive groups of patients receiving 1, 2, or 3 ALK inhibitors. Similar proportions of patients received crizotinib (52%) and alectinib (48%) as index ALK inhibitor. Prior to the index date, 40% of patients received chemotherapy. ALK inhibitor sequences are shown (Table). In patients who had discontinued all ALK inhibitors, the next treatments were chemotherapy (46%) and immunotherapy (6%). The most common sequence was a crizotinib-led sequence of 2 ALK inhibitors; median duration of treatment was 53 months. Changes in treatment patterns over time and further duration of treatment data will be presented.


      Overall Population

      N = 378

      n (%)
      1 ALK inhibitor (n=261)
      Crizotinib 91 (24.07)
      Alectinib 170 (44.97)
      2 ALK inhibitors (n=98)
      Crizotinib -> Alectinib 89 (23.54)
      Crizotinib -> Ceritinib 1 (0.26)
      Alectinib -> Crizotinib 7 (1.85)
      Alectinib -> Ceritinib 1 (0.26)
      3 ALK inhibitors (n=19)
      Crizotinib -> Alectinib -> Ceritinib 16 (4.23)
      Alectinib -> Crizotinib -> Ceritinib 3 (0.79)
      8eea62084ca7e541d918e823422bd82e Conclusion

      Treatment patterns in ALK-positive NSCLC patients have evolved over time. The most common sequence for patients receiving > 1 ALK inhibitor was crizotinib-led. Median duration of treatment with crizotinib-led sequences is consistent with what has been reported previously. Additional research is warranted to evaluate non-crizotinib-led sequences as data mature.


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