Clinical outcomes of patients with resected, early-stage ALK-positive lung cancer
| Autor: | Mark G. Kris, Juliana Eng, Benjamin Izar, Emily Chin, Justin F. Gainor, Fernando C. Santini, David R. Jones, Jamie E. Chaft, Ibiayi Dagogo-Jack, Alice T. Shaw, Beow Y. Yeap |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine Oncology Adult Male Cancer Research medicine.medical_specialty Lung Neoplasms Disease medicine.disease_cause Article Proto-Oncogene Proteins p21(ras) 03 medical and health sciences 0302 clinical medicine Internal medicine hemic and lymphatic diseases Carcinoma Non-Small-Cell Lung medicine Humans Anaplastic Lymphoma Kinase Stage (cooking) Lung cancer Pneumonectomy Aged Neoplasm Staging Aged 80 and over Gene Rearrangement Lung business.industry Medical record Hazard ratio Middle Aged medicine.disease Prognosis Survival Analysis United States respiratory tract diseases Clinical trial ErbB Receptors 030104 developmental biology medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Mutation Female KRAS business |
| Zdroj: | Lung cancer (Amsterdam, Netherlands). 122 |
| ISSN: | 1872-8332 |
| Popis: | Objectives Reports of the prognostic significance of ALK-rearrangement in resected non-small cell lung cancer (NSCLC) have been contradictory. We aimed to determine the prognosis of early-stage ALK-positive lung cancers relative to KRAS- and EGFR-mutant lung cancers. Material and methods We reviewed medical records of patients with resected NSCLC harboring an ALK rearrangement (n = 29) or a driver mutation in EGFR (n = 255) or KRAS (n = 480). Recurrence-free survival (RFS) was estimated for each genotype with the differences reported as a hazard ratio (HR). Results Among the 764 patients, 555 (73%), 101 (13%), and 108 (14%) had stage I, II, and III NSCLC, respectively. ALK-positive patients were distributed across all stages: 10 (34%) stage I, 6 (21%) stage II, and 13 (45%) stage III. Median RFS was not reached for EGFR-mutant patients, 24.3 months (95%CI 11.4–65.3) for ALK-positive patients, and 72.9 months (95%CI 59.7 to undefined) for KRAS-mutant patients. When adjusted for stage, ALK-positive NSCLC remained associated with worse RFS compared to EGFR-mutant (HR 1.8, 95%CI: 1.1-3.1), but not when compared to KRAS-mutant (HR 1.3, 95%CI: 0.8-2.1) NSCLC. Conclusions In this large series of resected NSCLC, ALK rearrangements were associated with a trend toward inferior disease outcomes compared to other clinically relevant genomic subsets. These data support the need for clinical trials evaluating use of ALK inhibitors among ALK-positive patients with localized or locally-advanced disease. |
| Databáze: | OpenAIRE |
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