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Lung Cancer. 2020 Jan;139:22-27. doi: 10.1016/j.lungcan.2019.10.015. Epub 2019 Oct 14.

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.

Author information

1
Chao Family Comprehensive Cancer Center, University of California, CA, USA. Electronic address: siou@uci.edu.
2
University of Michigan, Ann Arbor, MI, USA. Electronic address: sgadgeel@med.umich.edu.
3
Aix-Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France. Electronic address: fabrice.barlesi@ap-hm.fr.
4
National Taiwan University Hospital, Taipei City, Taiwan. Electronic address: chihyang@ntu.edu.tw.
5
Karolinska University Hospital, Stockholm, Sweden. Electronic address: luigi.depetris@ki.se.
6
Seoul National University Hospital, Seoul, South Korea. Electronic address: kimdw@snu.ac.kr.
7
Alvin J Siteman Cancer Center at Washington University School of Medicine, St. Louis, MO, USA. Electronic address: rgovinda@dom.wustl.edu.
8
Maastricht University Medical Centre, Maastricht, the Netherlands. Electronic address: a.dingemans@mumc.nl.
9
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy. Electronic address: lucio.crino@irst.emr.it.
10
Hopital Pontchaillou, Rennes, France. Electronic address: herve.lena@chu-rennes.fr.
11
The Royal Marsden Hospital, London, UK. Electronic address: sanjay.popat@rmh.nhs.uk.
12
Samsung Medical Center, Seoul, South Korea. Electronic address: jinseok.ahn@samsung.com.
13
Centre Oscar Lambret, Lille, France. Electronic address: e-dansin@o-lambret.fr.
14
F. Hoffmann-La Roche Ltd, Basel, Switzerland. Electronic address: e.mitry@me.com.
15
F. Hoffmann-La Roche Ltd, Basel, Switzerland. Electronic address: barbara.mueller.bm1@roche.com.
16
F. Hoffmann-La Roche Ltd, Basel, Switzerland. Electronic address: walter.bordogna@roche.com.
17
F. Hoffmann-La Roche Ltd, Basel, Switzerland. Electronic address: bogdana_ioana.balas@roche.com.
18
Roche Innovation Center, New York City, NY, USA. Electronic address: peter.morcos@roche.com.
19
Massachusetts General Hospital Cancer Center, Yawkey 7B, 32 Fruit Street, Boston, MA, USA. Electronic address: ashaw1@mgh.harvard.edu.

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.

KEYWORDS:

ALK+; Alectinib; NSCLC; Overall survival; Pooled analysis; Safety

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