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Background and Importance Alectinib had been approved for treatment of anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC). However, real-world evidence of alectinib as first-line for Asian population was still limited. Aim and Objectives Our study was aimed to estimate the clinical benefits and potential prognostic factors of alectinib for ALK-positive NSCLC treatment. Material and Methods We conducted a retrospective cohort study by analysing a multi-institutional electronic medical records data in Taiwan. We included NSCLC patients newly receiving alectinib as first-line ALK tyrosine kinase inhibitors (TKIs) from 1 January 2019 to 31 December 2021. We further excluded the patients with previous chemotherapy. The study outcomes included overall survival (OS) and treatment duration. We follow the patients from initiating alectinib to the occurrence of interest. outcomes, death, loss of follow up or end of data (31 March 2023), whichever came first. Prognostic factors for outcomes included patients' demographics (e.g., sex and age), Charlson comorbidity index (CCI), brain metastasis, gene mutation status, stage and Eastern Cooperative Oncology Group (ECOG). Uni-variable Cox regression model was applied to identify potential prognostic factors. Results We included a total of 109 NSCLC patients with newly receiving alectinib as a first-line ALK-TKIs with a median age of 62.0 years (range: 50.0–71.0), of whom 48.6% were female. Among 17.9 months follow-up, median OS was non-reach. Brain metastasis was insignificantly associated with worsen OS (HR: 1.57, 95% CI: 0.69–3.60). Moreover, we found elderly patients (HR: 2.57, 1.32–5.01), ECOG > 2 (HR: 5.05, 2.52–10.1) and CCI >5 (HR: 2.50, 1.31–4.78) were significantly related to better OS. Conclusion and Relevance Better patients' performance was associated with better OS in NSCLC patients with alectinib as first-line ALK-TKI. Future real-world studies with large sample size and longer follow-up time are suggested to confirm our findings. References and/or Acknowledgements Conflict of Interest No conflict of interest.
Hung et al. (2024) studied this question.