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Mridul Malhotra

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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      177P - Real-world experience of ALK positive NSCLC from India (ID 296)

      12:30 - 13:00  |  Presenting Author(s): Mridul Malhotra

      • Abstract
      • Slides


      ALK gene rearranged lung cancer is a rare subset of NSCLC. However, treatment with ALK inhibitors leads to a drastic improvement in outcomes. In this study, we have audited the outcomes of patients with ALK-rearranged NSCLC at our institute.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We conducted an audit of patients with ALK-rearranged NSCLC diagnosed between November 2011–December 2017 from a prospective database of lung cancer patients maintained by the authors. The basic demographic characteristics, treatment received, and the outcomes were noted. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan Meier method. This study was approved by the institutional ethics committee and was carried out in accordance with good clinical practice guidelines and the Declaration of Helsinki.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      We diagnosed 318 ALK-positive patients during November 2011–December 2017. The median age was 50 years (23-77 years); 189 patients (59.4%) were male and 129 (41.6%) were female. Only 57 (17.9%) were smokers. The ECOG PS was 0-1 in 195 patients (61.3%), 2 in 46 (14.5) and 3-4 in 33 (10.4%). Data on PS was missing in 44 patients (13.8%). The median number of sites of metastasis was 2 (0-7); brain metastases were seen in 38 patients (11.9%). The first line treatment received was as follows: crizotinib (either upfront or as a switch after a few cycles of doublet chemotherapy) in 202 patients (63.5%), pemetrexed platinum in 72 (22.6%), taxane platinum in 5 (1.6%), gemcitabine platinum in 5 (1.6%) and others in 33 (10.7%). The median PFS and median OS for the entire cohort was 11.0 months and 34.2 months, respectively. The hazard ratio (HR) favoured using crizotinib upfront (0.5, 95% CI 0.38-0.67, p < 0.001). Patients receiving upfront crizotinib had better PFS compared to those who received crizotinib as a switch after a few cycles of chemotherapy (HR: 0.66 (0.44-0.99) p-0.040). However, the median OS was similar between the two treatment strategies for crizotinib (p-0.964). The median OS in patients who never received crizotinib was 11.0 months while OS was not reached in patients who received crizotinib in any line (p< 0.001). The 5-year OS in patients receiving crizotinib in any line was 50.0%.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Crizotinib substantially improves outcomes in patients with ALK-rearranged NSCLC and is a suitable option where other ALK inhibitors are not available.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      IEC, TMH.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.


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