Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Alectinib has been established as a standard of care for patients with treatment-naive anaplastic lymphoma kinase-rearranged (ALK-positive) advanced non-small-cell lung cancer (NSCLC); however, it has rarely been compared with the sequential approach (crizotinib followed by alectinib) in China. This study aimed to compare real-world alectinib upfront data with either real-world sequential approach data or clinical trial first-line alectinib data.
Methods: The patients who received alectinib in the real-world setting were monitored from August 2016 to November 2020. The patients' characteristics were well balanced using the inverse probability of treatment weighting (IPTW) method. Real-world progression-free survival (rwPFS), real-world overall survival (rwOS), and real-world intracranial progression-free survival (rwiPFS) were calculated. To compare the effectiveness of alectinib in real-world setting with that in the ALEX study, data from the ALEX study were analyzed.
Results: This study included 311 patients who were divided into three groups: alectinib group (n=102), sequential group (n=63), and alectinib group in ALEX (n=146). The rwPFS and rwOS were similar between the alectinib and sequential groups. However, alectinib group was associated with a lower risk of central nervous system progression than sequential group. Compared with alectinib group in ALEX, the alectinib group in the real world had a significantly longer PFS [hazard ratio (HR), 0.57; 95% confidence interval (CI): 0.37-0.89; P=0.01] and OS (HR, 0.42; 95% CI: 0.21-0.82; P=0.01) after IPTW.
Conclusions: Our real world data suggested that sequential group was associated with a higher risk of progression in the brain than the alectinib upfront treatment. However, both treatments had similar survival in advanced ALK-positive NSCLC. Patients with advanced ALK-positive NSCLC in the real-world setting had significantly improved outcomes than those in the ALEX study.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082225 | PMC |
| http://dx.doi.org/10.21037/tlcr-24-898 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Molecularly matched targeted therapies plus radiotherapy in glioblastoma: the phase 1/2a NM umbrella trial.
Nat Med
September 2025
Neurology, University Clinic Heidelberg, Heidelberg University & German Cancer Consortium (DKTK) and CCU Neurooncology, German Cancer Research Center, Heidelberg, Germany.
Advances in molecular understanding and diagnostic precision of glioblastoma enable the identification of key genetic alterations in a timely manner and, in principle, allow treatments with targeted compounds based on molecular markers. Here we report the results of the phase 1/2 umbrella trial NCT Neuro Master Match (NM), which evaluated targeted treatments in 228 patients with newly diagnosed glioblastoma without O6-methylguanine DNA-methyltransferase promoter hypermethylation. Stratification for treatment was conducted by a trial-specific molecular tumor board across five subtrials, each evaluating a targeted therapy-alectinib, idasanutlin, palbociclib, vismodegib or temsirolimus-selected according to the best-matching molecular alteration.
View Article and Find Full Text PDFPlasma cfDNA analysis of alectinib resistance-related gene alterations in the J-ALEX study.
ESMO Open
September 2025
Department of Medical Oncology, Kanazawa University Hospital, Kanazawa, Japan. Electronic address:
Background: Resistance to alectinib, the standard first-line therapy for anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC), remains a major clinical challenge. This study aimed to investigate resistance mechanisms using next-generation sequencing (NGS) of plasma cell-free DNA (cfDNA).
Materials And Methods: Plasma samples from 67 patients in the alectinib group of the J-ALEX study were collected at baseline, on day 57, and at treatment discontinuation.
Early Weight Gain as a Risk Factor for Increased Maximum Weight Gain Among Patients With NSCLC on Lorlatinib and Other ALK Tyrosine Kinase Inhibitors.
JTO Clin Res Rep
September 2025
Anschutz Health and Wellness Center, Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Introduction: Therapy-associated weight gain affects the quality of life and health of patients with ALK-positive NSCLC treated with tyrosine kinase inhibitors (TKIs). The severity and timing of real-world weight gain on ALK TKIs and associated risk factors are poorly understood, impairing timely interventions.
Methods: A retrospective chart review of patients with ALK-positive NSCLC receiving TKIs at our institution from January 1, 2020 to December 31, 2023 was conducted.
Magnesium Isoglycyrrhizinate Alleviates Alectinib-Induced Hepatotoxicity by Inhibiting Mitochondrial Damage-Mediated Pyroptosis.
Drug Des Devel Ther
July 2025
Clinical Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Introduction: Alectinib is a widely used first-line ALK inhibitor for fusion-positive non-small cell lung cancer. However, its clinical use is limited by hepatotoxicity, and its mechanism remains unclear. This study aims to elucidate how alectinib induces liver injury and to explore a potential protective strategy.
View Article and Find Full Text PDFDrug Repurposing for Targeting ISL LIM Homeobox 2 in Treatment of Endometriosis: A Computational Study.
Int J Fertil Steril
May 2025
Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Email:
Background: Endometriosis is a prevalent women's health disorder that lacks a definitive cure. Numerous studies have been conducted to identify the underlying causes of this disease and select the most effective pharmaceutical intervention. ISL LIM homeobox 2 (ISL2) plays a significant role in promoting angiogenesis.
View Article and Find Full Text PDF