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. 2022 Aug 26;101(34):e30188.
doi: 10.1097/MD.0000000000030188.

Evaluation of clinicopathological features determining treatment response in patients with ALK mutant NSCLC

Izzet Dogan  1 , Mustafa Gurbuz  2 , Nail Paksoy  1 , Ferhat Ferhatoglu  1 , Sezai Vatansever  1 , Pinar Saip  1 , Ahmet Demirkazik  2 , Adnan Aydiner  1
Affiliations

Evaluation of clinicopathological features determining treatment response in patients with ALK mutant NSCLC

Izzet Dogan et al. Medicine (Baltimore). .

Abstract

ALK (anaplastic lymphoma kinase) inhibitors may be used to treat patients with ALK mutant metastatic nonsmall cell cancer (NSCLC). This study aimed to investigate the factors affecting the patients response to treatment with ALK-positive metastatic NSCLC. Data of the patients were investigated retrospectively. Binary regression analysis was performed to evaluate response predictors of treatment. Furthermore, we determined the cut-off value of the ALK-positivity for objective response to the therapy using ROC analysis. A total of 68 patients were included in the research. The median overall survival was observed 39.2 months. The overall response rate was 66.2%. The ratio of ALK positivity (P = .02), gender (P = .04), and the total number of metastatic sites (P = .02) all were detected as predictors of the response to ALK inhibitor in binary regression analysis. ALK inhibitor type (P = .56), primary tumor location (P = .35), pathological subtype (P = .68), de-novo metastatic disease (P = .28), and age (P = .94) were not predictive indicators for response. The cut-off level of ALK positivity was found to be 33% in patients with an objective response. The real-life effectiveness of ALK inhibitors in NSCLC patients with ALK mutations was shown in this research. We determined that having less than 3 metastatic sites, having a high ALK positivity ratio, and being female were all good predictors of ALK inhibitor response.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Kaplan Meier curves for PFS in the patients.
Figure 2.
Figure 2.
Kaplan Meier curve for OS in the patients.
Figure 3.
Figure 3.
ROC curve by ALK positivity ratio for treatment response. (P = .002, AUC:0.740, sensitivity 57.5%, specificity 78.3%)
Figure 4.
Figure 4.
Kaplan-Meier curves for PFS by ALK positivity rate.
Figure 5.
Figure 5.
Kaplan-Meier curves for OS by ALK positivity rate.
See this image and copyright information in PMC

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