Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials

Abstract Background Whereas there are many pharmacological interventions prescribed for patients with advanced anaplastic lymphoma kinase (ALK)- rearranged non-small cell lung cancer (NSCLC), comparative data between novel generation ALK-tyrosine kinase inhibitors (TKIs) remain scant. Here, we indir...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hao-chuan Ma, Yi-hong Liu, Kai-lin Ding, Yu-feng Liu, Wen-jie Zhao, Yan-juan Zhu, Xue-song Chang, Ya-dong Chen, Zhen-zhen Xiao, Ya-ya Yu, Rui Zhou, Hai-bo Zhang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	ALK Lung cancer First-line treatment Network meta-analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/6543667632434346976330ca1a6114d6
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:6543667632434346976330ca1a6114d6
record_format	dspace
spelling	oai:doaj.org-article:6543667632434346976330ca1a6114d62021-11-28T12:27:40ZComparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials10.1186/s12885-021-08977-01471-2407https://doaj.org/article/6543667632434346976330ca1a6114d62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08977-0https://doaj.org/toc/1471-2407Abstract Background Whereas there are many pharmacological interventions prescribed for patients with advanced anaplastic lymphoma kinase (ALK)- rearranged non-small cell lung cancer (NSCLC), comparative data between novel generation ALK-tyrosine kinase inhibitors (TKIs) remain scant. Here, we indirectly compared the efficacy and safety of first-line systemic therapeutic options used for the treatment of ALK-rearranged NSCLC. Methods We included all phase 2 and 3 randomised controlled trials (RCTs) comparing any two or three treatment options. Eligible studies reported at least one of the following outcomes: progression free survival (PFS), overall survival (OS), objective response rate (ORR), or adverse events of grade 3 or higher (Grade ≥ 3 AEs). Subgroup analysis was conducted according to central nervous system (CNS) metastases. Results A total of 9 RCTs consisting of 2484 patients with 8 treatment options were included in the systematic review. Our analysis showed that alectinib (300 mg and 600 mg), brigatinib, lorlatinib and ensartinib yielded the most favorable PFS. Whereas there was no significant OS or ORR difference among the ALK-TKIs. According to Bayesian ranking profiles, lorlatinib, alectinib 600 mg and alectinib 300 mg had the best PFS (63.7%), OS (35.9%) and ORR (37%), respectively. On the other hand, ceritinib showed the highest rate of severe adverse events (60%). Conclusion Our analysis indicated that alectinib and lorlatinib might be associated with the best therapeutic efficacy in first-line treatment for major population of advanced NSCLC patients with ALK-rearrangement. However, since there is little comparative evidence on the treatment options, there is need for relative trials to fully determine the best treatment options as well as the rapidly evolving treatment landscape.Hao-chuan MaYi-hong LiuKai-lin DingYu-feng LiuWen-jie ZhaoYan-juan ZhuXue-song ChangYa-dong ChenZhen-zhen XiaoYa-ya YuRui ZhouHai-bo ZhangBMCarticleALKLung cancerFirst-line treatmentNetwork meta-analysisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ALK Lung cancer First-line treatment Network meta-analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	ALK Lung cancer First-line treatment Network meta-analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Hao-chuan Ma Yi-hong Liu Kai-lin Ding Yu-feng Liu Wen-jie Zhao Yan-juan Zhu Xue-song Chang Ya-dong Chen Zhen-zhen Xiao Ya-ya Yu Rui Zhou Hai-bo Zhang Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials
description	Abstract Background Whereas there are many pharmacological interventions prescribed for patients with advanced anaplastic lymphoma kinase (ALK)- rearranged non-small cell lung cancer (NSCLC), comparative data between novel generation ALK-tyrosine kinase inhibitors (TKIs) remain scant. Here, we indirectly compared the efficacy and safety of first-line systemic therapeutic options used for the treatment of ALK-rearranged NSCLC. Methods We included all phase 2 and 3 randomised controlled trials (RCTs) comparing any two or three treatment options. Eligible studies reported at least one of the following outcomes: progression free survival (PFS), overall survival (OS), objective response rate (ORR), or adverse events of grade 3 or higher (Grade ≥ 3 AEs). Subgroup analysis was conducted according to central nervous system (CNS) metastases. Results A total of 9 RCTs consisting of 2484 patients with 8 treatment options were included in the systematic review. Our analysis showed that alectinib (300 mg and 600 mg), brigatinib, lorlatinib and ensartinib yielded the most favorable PFS. Whereas there was no significant OS or ORR difference among the ALK-TKIs. According to Bayesian ranking profiles, lorlatinib, alectinib 600 mg and alectinib 300 mg had the best PFS (63.7%), OS (35.9%) and ORR (37%), respectively. On the other hand, ceritinib showed the highest rate of severe adverse events (60%). Conclusion Our analysis indicated that alectinib and lorlatinib might be associated with the best therapeutic efficacy in first-line treatment for major population of advanced NSCLC patients with ALK-rearrangement. However, since there is little comparative evidence on the treatment options, there is need for relative trials to fully determine the best treatment options as well as the rapidly evolving treatment landscape.
format	article
author	Hao-chuan Ma Yi-hong Liu Kai-lin Ding Yu-feng Liu Wen-jie Zhao Yan-juan Zhu Xue-song Chang Ya-dong Chen Zhen-zhen Xiao Ya-ya Yu Rui Zhou Hai-bo Zhang
author_facet	Hao-chuan Ma Yi-hong Liu Kai-lin Ding Yu-feng Liu Wen-jie Zhao Yan-juan Zhu Xue-song Chang Ya-dong Chen Zhen-zhen Xiao Ya-ya Yu Rui Zhou Hai-bo Zhang
author_sort	Hao-chuan Ma
title	Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials
title_short	Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials
title_full	Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials
title_fullStr	Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials
title_full_unstemmed	Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials
title_sort	comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with alk-rearranged: a meta-analysis of clinical trials
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6543667632434346976330ca1a6114d6
work_keys_str_mv	AT haochuanma comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT yihongliu comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT kailinding comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT yufengliu comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT wenjiezhao comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT yanjuanzhu comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT xuesongchang comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT yadongchen comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT zhenzhenxiao comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT yayayu comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT ruizhou comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials AT haibozhang comparativeefficacyandsafetyoffirstlinetreatmentsforadvancednonsmallcelllungcancerwithalkrearrangedametaanalysisofclinicaltrials
_version_	1718407958631546880

Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials

Ejemplares similares