Clinical outcomes of patients with resected, early-stage ALK-positive lung cancer Journal Article
| Authors: | Chaft, J. E.; Dagogo-Jack, I.; Santini, F. C.; Eng, J.; Yeap, B. Y.; Izar, B.; Chin, E.; Jones, D. R.; Kris, M. G.; Shaw, A. T.; Gainor, J. F. |
| Article Title: | Clinical outcomes of patients with resected, early-stage ALK-positive lung cancer |
| Abstract: | Objectives: Reports of the prognostic significance of ALK-rearrangement in resected non-small cell lung cancer (NSCLC) have been contradictory. We aimed to determine the prognosis of early-stage ALK-positive lung cancers relative to KRAS- and EGFR-mutant lung cancers. Material and methods: We reviewed medical records of patients with resected NSCLC harboring an ALK rearrangement (n = 29) or a driver mutation in EGFR (n = 255) or KRAS (n = 480). Recurrence-free survival (RFS) was estimated for each genotype with the differences reported as a hazard ratio (HR). Results: Among the 764 patients, 555 (73%), 101 (13%), and 108 (14%) had stage I, II, and III NSCLC, respectively. ALK-positive patients were distributed across all stages: 10 (34%) stage I, 6 (21%) stage II, and 13 (45%) stage III. Median RFS was not reached for EGFR-mutant patients, 24.3 months (95%CI 11.4–65.3) for ALK-positive patients, and 72.9 months (95%CI 59.7 to undefined) for KRAS-mutant patients. When adjusted for stage, ALK-positive NSCLC remained associated with worse RFS compared to EGFR-mutant (HR 1.8, 95%CI: 1.1-3.1), but not when compared to KRAS-mutant (HR 1.3, 95%CI: 0.8-2.1) NSCLC. Conclusions: In this large series of resected NSCLC, ALK rearrangements were associated with a trend toward inferior disease outcomes compared to other clinically relevant genomic subsets. These data support the need for clinical trials evaluating use of ALK inhibitors among ALK-positive patients with localized or locally-advanced disease. © 2018 |
| Keywords: | early-stage non-small cell lung cancer; alk-rearrangement |
| Journal Title: | Lung Cancer |
| Volume: | 122 |
| ISSN: | 0169-5002 |
| Publisher: | Elsevier Ireland Ltd. |
| Date Published: | 2018-08-01 |
| Start Page: | 67 |
| End Page: | 71 |
| Language: | English |
| DOI: | 10.1016/j.lungcan.2018.05.020 |
| PROVIDER: | scopus |
| PMCID: | PMC6062851 |
| PUBMED: | 30032847 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 July 2018 -- Source: Scopus |
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