Pooled overall survival and safety data from the pivotal phase II studies (NP28673 and NP28761) of alectinib in ALK-positive non-small-cell lung cancer. (January 2020)

• Record Type: Journal Article
• Authors: Ou, Sai-Hong Ignatius; Gadgeel, Shirish M.; Barlesi, Fabrice; Yang, James Chih-Hsin; De Petris, Luigi; Kim, Dong-Wan; Govindan, Ramaswamy; Dingemans, Anne-Marie; Crino, Lucio; Léna, Hervé; Popat, Sanjay; Ahn, Jin Seok; Dansin, Eric; Mitry, Emmanuel; Müller, Barbara; Bordogna, Walter; Balas, Bogdana; Morcos, Peter N.; Shaw, Alice T.
• Is Part Of: Lung cancer. Volume 139(2020)
• Page Start: 22
• Page End: 27
• Publication Date: 2020-01
• Subjects: AE adverse event -- ALK+ anaplastic lymphoma kinase-positive -- ALT alanine aminotransferase -- AST aspartate aminotransferase -- CI confidence interval -- CNS central nervous system -- CPK creatine phosphokinase -- ECOG PS Eastern Cooperative Oncology Group performance status -- IRC independent review committee -- NE not estimable -- NR not reported -- NSCLC non-small-cell lung cancer -- OS overall survival -- PFS progression-free survival -- SAE serious adverse event -- TRAE treatment-related adverse event -- URTI upper respiratory tract infection; Alectinib -- ALK+ -- NSCLC -- Overall survival -- Pooled analysis -- Safety; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2019.10.015
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Pooled OS/safety data from the pivotal phase II studies of alectinib in ALK + NSCLC. Alectinib demonstrated a final pooled median OS of 29.1 months (95% CI 21.3–39.0). No new or unexpected safety findings were observed. Alectinib shows robust efficacy and manageable safety in advanced ALK + NSCLC. Abstract: Objectives: A pooled analysis of two open-label phase II studies of alectinib (NP28673 [NCT01801111] and NP28761 [NCT01871805]) demonstrated clinical activity in patients with advanced, anaplastic lymphoma kinase-positive ( ALK +) non-small-cell lung cancer (NSCLC) previously treated with crizotinib. Longer-term and final pooled analyses of overall survival (OS) and safety data from the two studies are presented here. Patients and methods: The pooled population totaled 225 patients (NP28673: n = 138, NP28761: n = 87) who received 600 mg oral alectinib twice daily until disease progression, death, or withdrawal. OS was defined as the time from date of first treatment to date of death, regardless of cause. OS was estimated using Kaplan–Meier methodology, with 95% confidence intervals (CIs) determined using the Brookmeyer–Crowley method. Safety was assessed through adverse event (AE) reporting. Results: Baseline characteristics were generally comparable between the studies. At final data cutoff (October 27, 2017 [NP28673], October 12, 2017 [NP28761]; median pooled follow-up time, ∼21 months), 53.3% of patients had died, 39.1% were alive and in follow-up, and 7.6% had withdrawn consent or were lost to follow-up. Alectinib demonstrated a median OS of 29.1 months (95% CI 21.3–39.0). No new or unexpected safety findings were observed. The most common all-grade AEs included constipation (39.1%), fatigue (35.1%), peripheral edema (28.4%), myalgia (26.2%), and nausea (24.0%). Conclusion: Updated results from this pooled analysis further demonstrate that alectinib has robust clinical activity and a manageable safety profile in patients with advanced, ALK + NSCLC pretreated with crizotinib.