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Kilickap S, Ozturk A, Karadurmus N, Korkmaz T, Yumuk PF, Cicin I, Paydas S, Cilbir E, Sakalar T, Uysal M, Yesil Cinkir H, Uskent N, Demir N, Sakin A, Dursun OU, Aver B, Turhal NS, Keskin S, Tural D, Eralp Y, Bugdayci Basal F, Yasar HA, Sendur MAN, Demirci U, Cubukcu E, Karaagac M, Cakar B, Tatli AM, Yetisyigit T, Urvay S, Gursoy P, Oyan B, Turna ZH, Isikdogan A, Olmez OF, Yazici O, Cabuk D, Seker MM, Unal OU, Meydan N, Okutur SK, Tunali D, Erman M. A multicenter, retrospective archive study of radiological and clinical features of ALK-positive non-small cell lung cancer patients and crizotinib efficacy. Medicine (Baltimore) 2024; 103:e37972. [PMID: 38787994 PMCID: PMC11124701 DOI: 10.1097/md.0000000000037972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/29/2024] [Indexed: 05/26/2024] Open
Abstract
To evaluate radiological and clinical features in metastatic anaplastic lymphoma kinase+ non-small cell lung cancer patients and crizotinib efficacy in different lines. This national, non-interventional, multicenter, retrospective archive screening study evaluated demographic, clinical, and radiological imaging features, and treatment approaches in patients treated between 2013-2017. Totally 367 patients (54.8% males, median age at diagnosis 54 years) were included. Of them, 45.4% were smokers, and 8.7% had a family history of lung cancer. On radiological findings, 55.9% of the tumors were located peripherally, 7.7% of the patients had cavitary lesions, and 42.9% presented with pleural effusion. Pleural effusion was higher in nonsmokers than in smokers (37.3% vs. 25.3%, P = .018). About 47.4% of cases developed distant metastases during treatment, most frequently to the brain (26.2%). Chemotherapy was the first line treatment in 55.0%. Objective response rate was 61.9% (complete response: 7.6%; partial response: 54.2%). The highest complete and partial response rates were observed in patients who received crizotinib as the 2nd line treatment. The median progression-free survival was 14 months (standard error: 1.4, 95% confidence interval: 11.2-16.8 months). Crizotinib treatment lines yielded similar progression-free survival (P = .078). The most frequent treatment-related adverse event was fatigue (14.7%). Adrenal gland metastasis was significantly higher in males and smokers, and pleural involvement and effusion were significantly higher in nonsmokers-a novel finding that has not been reported previously. The radiological and histological characteristics were consistent with the literature data, but several differences in clinical characteristics might be related to population characteristics.
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Affiliation(s)
- Saadettin Kilickap
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
- Department of Medical Oncology, Istinye University Faculty of Medicine, Istanbul, Turkey
- Ankara Liv Hospital, Medical Oncology, Ankara, Turkey
| | - Akin Ozturk
- Department of Medical Oncology, Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey
| | - Nuri Karadurmus
- Department of Medical Oncology, University of Health Sciences Gulhane Training and Research Hospital, Ankara, Turkey
| | - Taner Korkmaz
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, Turkey
| | - Perran Fulden Yumuk
- Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
- Medical Oncology Division, Koc University, School of Medicine, Istanbul, Turkey
| | - Irfan Cicin
- Department of Medical Oncology, Trakya University Medical Faculty, Edirne, Turkey
- Istinye University Medical Center, Istanbul, Turkey
| | - Semra Paydas
- Department of Internal Diseases, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Ebru Cilbir
- Department of Medical Oncology, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Teoman Sakalar
- Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | - Mukremin Uysal
- Department of Medical Oncology, Afyon Kocatepe University Faculty of Medicine, Afyon, Turkey
- Medstar Antalya Hospital, Medical Oncology Cancer Center, Antalya, Turkey
- Antalya Bilim University, Institute of Health Sciences, Antalya, Turkey
| | - Havva Yesil Cinkir
- Department of Internal Diseases, Gaziantep University Faculty of Medicine, Division of Medical Oncology, Gaziantep, Turkey
| | - Necdet Uskent
- Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey
| | - Necla Demir
- Sivas Numune Training and Research Hospital, Medical Oncology, Sivas, Turkey
- Acibadem Health Group, Kayseri Hospital, Unit of Medical Oncology, Kayseri, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Istanbul Prof. Dr. Cemil Tascioglu City Hospital (University of Health Sciences Okmeydani Training and Research Hospital), Istanbul, Turkey
- Division of Medical Oncology, Medipol University, Medipol Bahcelievler Hospital, Istanbul, Turkey
| | | | | | | | - Serkan Keskin
- Department of Oncology, Memorial Sisli Hospital, Istanbul, Turkey
| | - Deniz Tural
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Clinic of Medical Oncology, Istanbul, Turkey
| | - Yesim Eralp
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
- Acibadem Mehmet Ali Aydinlar University, Institute of Senology, Istanbul, Turkey
- Acibadem Healthcare Group, Maslak Hospital, Unit of Medical Oncology, Istanbul, Turkey
| | - Fatma Bugdayci Basal
- Department of Medical Oncology, Ankara Ataturk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
- Department of Medical Oncology, Lösante Children’s and Adult Hospital, Ankara, Turkey
| | - Hatime Arzu Yasar
- Department of Medical Oncology, Lösante Children’s and Adult Hospital, Ankara, Turkey
- Department of Medical Oncology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Mehmet Ali Nahit Sendur
- Ankara Atatürk Training and Research Hospital, Clinic of Medical Oncology, Ankara, Turkey
- Department of Internal Medicine, Medical Oncology Division, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Umut Demirci
- Department of Medical Oncology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
- Department of Medical Oncology, Memorial Hospital, Ankara, Turkey
- Department of Internal Medicine and Medical Oncology, Medical Sciences Division, Uskudar University, Faculty of Medicine, Istanbul, Turkey
| | - Erdem Cubukcu
- Department of Internal Diseases, Medical Oncology, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey
- Medicana Health Group-Bursa Hospital, Medical Oncology, Bursa, Turkey
| | - Mustafa Karaagac
- Department of Internal Diseases, Division of Medical Oncology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey
| | - Burcu Cakar
- Department of Internal Diseases, Ege University Faculty of Medicine Tulay Aktas Oncology Hospital, Izmir, Turkey
| | - Ali Murat Tatli
- Department of Internal Diseases, Division of Medical Oncology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Tarkan Yetisyigit
- Department of Medical Oncology, Tekirdag Namik Kemal University, Faculty of Medicine, Tekirdag, Turkey
- Department of Medical Oncology, King Hamad University Hospital, Bahrain Oncology Center, Manama, Kingdom of Bahrain
| | - Semiha Urvay
- Department of Internal Diseases, Kayseri Acibadem Hospital, Medical Oncology, Kayseri, Turkey
| | - Pinar Gursoy
- Department of Medical Oncology, University of Health Sciences Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Izmir, Turkey
- Department of Internal Diseases, Medical Oncology Division, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Basak Oyan
- Department of Medical Oncology, Acibadem University, School of Medicine, Istanbul, Turkey
| | - Zeynep Hande Turna
- Department of Internal Diseases, Division of Medical Oncology, Istanbul University Cerrahpasa, Faculty of Medicine, Istanbul, Turkey
| | - Abdurrahman Isikdogan
- Department of Medical Oncology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey
| | - Omer Fatih Olmez
- Department of Medical Oncology, Medipol University, Faculty of Medicine, Istanbul, Turkey
| | - Ozan Yazici
- University of Health Sciences, Ankara Numune Training and Research Hospital, Clinic of Medical Oncology, Ankara, Turkey
- Department of Internal Diseases, Medical Oncology Division, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Devrim Cabuk
- Department of Internal Diseases, Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Istanbul, Turkey
| | - Mehmet Metin Seker
- Department of Medical Oncology, Bayindir Hospital Sogutozu, Ankara, Turkey
- Department of Medical Oncology, Koru Health Group, Ankara, Turkey
| | - Olcun Umit Unal
- Department of Medical Oncology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
- Department of Medical Oncology-Chemotherapy, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Nezih Meydan
- Department of Medical Oncology, Adnan Menderes University, Faculty of Medicine, Aydin, Turkey
- Department of Medical Oncology, Medicana Health Group, Istanbul, Turkey
| | - Sadi Kerem Okutur
- Department of Medical Oncology, Medical Park Bahcelievler Hospital, Istanbul, Turkey
- Department of Medical Oncology, Memorial Hospital, Istanbul, Turkey
- Department of Medical Oncology, Istanbul Arel University, Istanbul, Turkey
| | - Didem Tunali
- Department of Medical Oncology, Koc University, Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Erman
- Departments of Preventive and Medical Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
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Zhang Q, Lv J, Li X, Zhang H, Zhu C, Wang M, Si M, Hu Y, Zhang S. Efficacy and safety of iruplinalkib (WX‑0593) on non‑small cell lung cancer with SPECC1L‑ALK fusion: A case report. Exp Ther Med 2024; 27:53. [PMID: 38234623 PMCID: PMC10790168 DOI: 10.3892/etm.2023.12341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/02/2023] [Indexed: 01/19/2024] Open
Abstract
The evidence of anaplastic lymphoma kinase (ALK) inhibitor for non-small cell lung cancer (NSCLC) harbouring sperm antigen with calponin homology and coiled-coil domains 1-like (SPECC1L)-ALK fusion was limited. In a previous case report, a Chinese, 44-year-old, female non-smoker with stage IV NSCLC harbouring SPECC1L-ALK fusion was treated with crizotinib ± bevacizumab for 23 months (from October 2017 to September 2019) and second-generation ALK inhibitor iruplinalkib for 2.5 months (from October 2019 to January 2020). The present study is an updated case report of subsequent follow-up of this patient. The patient participated in the phase II INTELLECT study and received iruplinalkib 180 mg once daily with a 7-day lead-in phase at 60 mg once daily. Systemic partial response was achieved 1 month later. Intracranial complete response was achieved nearly 5 months after iruplinalkib treatment initiation. Systemic and intracranial responses continued as of cut-off date (February 2023). The progression-free survival reached 39.3 months, with right censoring (progression did not occur during follow-up). Grade 3 hypertriglyceridaemia complicated with grade 2 hypercholesterolaemia recovered after fenofibrate treatment. The other adverse events were not noteworthy. Iruplinalkib demonstrated promising systemic and intracranial efficacy for NSCLC harbouring SPECC1L-ALK gene, with acceptable and manageable adverse events (for example, grade 3 hypertriglyceridaemia or grade 2 hypercholesterolaemia). Iruplinalkib may be an ideal option for patients with rare ALK fusions.
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Affiliation(s)
- Quan Zhang
- Department of Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Oncology Institute, Beijing 101149, P.R. China
| | - Jialin Lv
- Department of Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Oncology Institute, Beijing 101149, P.R. China
| | - Xi Li
- Department of Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Oncology Institute, Beijing 101149, P.R. China
| | - Hui Zhang
- Department of Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Oncology Institute, Beijing 101149, P.R. China
| | - Chenlin Zhu
- Department of Medical Affairs, Qilu Pharmaceutical Co., Ltd., Jinan, Shandong 250100, P.R. China
| | - Meng Wang
- Department of Medical Affairs, Qilu Pharmaceutical Co., Ltd., Jinan, Shandong 250100, P.R. China
| | - Meimei Si
- Clinical Research Centre, Qilu Pharmaceutical Co., Ltd., Jinan, Shandong 250100, P.R. China
| | - Ying Hu
- Department of Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Oncology Institute, Beijing 101149, P.R. China
| | - Shucai Zhang
- Department of Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Oncology Institute, Beijing 101149, P.R. China
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