Weight, BSA, Toxicity, and Efficacy of Tyrosine Kinase Inhibitors for ALK-Mutated NSCLC

Introduction: ALK tyrosine kinase inhibitors (ALK TKIs) are started at a standard dose regardless of patients' weight and body surface area (BSA). In this retrospective analysis, the authors explored whether body size variables were associated with toxicity and efficacy. Methods: positive patients at the Princess Margaret Cancer Centre were extracted from electronic health records. Associations between BSA/weight quartiles and dose reductions (DRs), temporary interruptions (TIs), and permanent discontinuation due to toxicity were evaluated using generalized linear mixed modeling. Survival analysis was conducted using Kaplan-Meier curves and log-rank tests. Results: 0.6). Conclusions: Higher weight and larger BSA at the start of ALK TKI treatment were associated with higher likelihood of toxicity, leading to more DRs and TIs-particularly in males and patients receiving alectinib and lorlatinib. However, weight and BSA were not associated with treatment outcomes.