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Treatment Patterns and Outcomes in a Cohort of Finnish NSCLC Patients with ALK Rearrangement Reflect Rapid Evolution in Treatment Practices

Received: 30 November 2021     Accepted: 15 December 2021     Published: 24 December 2021
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Abstract

Background: In Finland approximately 2,500 people are diagnosed with lung cancer annually. A small proportion of non-small cell lung cancer (NSCLC) patients (3–7%) have tumorigenic rearrangement of the anaplastic lymphoma kinase (ALK) gene (ALK-positive). ALK tyrosine kinase inhibitors (TKI) are the standard of care for these patients, showing superior efficacy compared to traditional chemotherapy (CT). Due to the rapid development of novel next-generation ALK TKIs, treatment practices have undergone substantial changes. In Finnish real-life clinical practice the choice of treatment is largely determined by the reimbursement status of available drugs. We set out to assess the prevailing treatment practices and outcomes for NSCLC patients harbouring ALK rearrangement. Materials and methods: This was a retrospective, non-interventional, two-centre study. Adult NSCLC patients from the Hospital District of Southwest Finland and ALK-positive NSCLC patients from the Hospital District of Helsinki and Uusimaa diagnosed between 2013–2017 were included. Patients were followed until death or until the end of study period (May 2018). Data were extracted retrospectively from electronic health records from University Hospital data lakes. Results: A total of 1,260 patients were included, of which 60 were ALK-positive. ALK TKI regimens were mainly received in second and later lines of treatment. Median time-to-next treatment (TTNT) during ALK TKI treatment was 11.0 months (95% CI; 5.0–35.0) and during CT treatment 7.0 months (5.0–11.0) when assessed irrespective of treatment line (p=0.08). Patients who received at least one ALK TKI treatment regimen during the follow-up had median overall survival (OS) of 33.6 months (16.9–NR) from diagnosis vs. 11.5 months (4.6–NR) in patients who were treated with CT regimens only (p=0.054). Conclusions: ALK-positive patients benefit from treatment with ALK targeting agents in real-world clinical practice.

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 7, Issue 6)
DOI 10.11648/j.ijcems.20210706.16
Page(s) 200-209
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

ALK Rearrangement, Non-small Cell Lung Cancer, Chemotherapy, ALK Tyrosine Kinase Inhibitor, Crizotinib, Data Lake

References
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Cite This Article
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    Heidi Loponen, Juuso Paajanen, Ville Vihervaara, Saija Ylä-Viteli, Klaus Tamminen, et al. (2021). Treatment Patterns and Outcomes in a Cohort of Finnish NSCLC Patients with ALK Rearrangement Reflect Rapid Evolution in Treatment Practices. International Journal of Clinical and Experimental Medical Sciences, 7(6), 200-209. https://doi.org/10.11648/j.ijcems.20210706.16

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    ACS Style

    Heidi Loponen; Juuso Paajanen; Ville Vihervaara; Saija Ylä-Viteli; Klaus Tamminen, et al. Treatment Patterns and Outcomes in a Cohort of Finnish NSCLC Patients with ALK Rearrangement Reflect Rapid Evolution in Treatment Practices. Int. J. Clin. Exp. Med. Sci. 2021, 7(6), 200-209. doi: 10.11648/j.ijcems.20210706.16

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    AMA Style

    Heidi Loponen, Juuso Paajanen, Ville Vihervaara, Saija Ylä-Viteli, Klaus Tamminen, et al. Treatment Patterns and Outcomes in a Cohort of Finnish NSCLC Patients with ALK Rearrangement Reflect Rapid Evolution in Treatment Practices. Int J Clin Exp Med Sci. 2021;7(6):200-209. doi: 10.11648/j.ijcems.20210706.16

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  • @article{10.11648/j.ijcems.20210706.16,
      author = {Heidi Loponen and Juuso Paajanen and Ville Vihervaara and Saija Ylä-Viteli and Klaus Tamminen and Saku Torvinen4 and Jari Jokelainen and Tero Ylisaukko-oja and Maria Silvoniemi},
      title = {Treatment Patterns and Outcomes in a Cohort of Finnish NSCLC Patients with ALK Rearrangement Reflect Rapid Evolution in Treatment Practices},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {7},
      number = {6},
      pages = {200-209},
      doi = {10.11648/j.ijcems.20210706.16},
      url = {https://doi.org/10.11648/j.ijcems.20210706.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20210706.16},
      abstract = {Background: In Finland approximately 2,500 people are diagnosed with lung cancer annually. A small proportion of non-small cell lung cancer (NSCLC) patients (3–7%) have tumorigenic rearrangement of the anaplastic lymphoma kinase (ALK) gene (ALK-positive). ALK tyrosine kinase inhibitors (TKI) are the standard of care for these patients, showing superior efficacy compared to traditional chemotherapy (CT). Due to the rapid development of novel next-generation ALK TKIs, treatment practices have undergone substantial changes. In Finnish real-life clinical practice the choice of treatment is largely determined by the reimbursement status of available drugs. We set out to assess the prevailing treatment practices and outcomes for NSCLC patients harbouring ALK rearrangement. Materials and methods: This was a retrospective, non-interventional, two-centre study. Adult NSCLC patients from the Hospital District of Southwest Finland and ALK-positive NSCLC patients from the Hospital District of Helsinki and Uusimaa diagnosed between 2013–2017 were included. Patients were followed until death or until the end of study period (May 2018). Data were extracted retrospectively from electronic health records from University Hospital data lakes. Results: A total of 1,260 patients were included, of which 60 were ALK-positive. ALK TKI regimens were mainly received in second and later lines of treatment. Median time-to-next treatment (TTNT) during ALK TKI treatment was 11.0 months (95% CI; 5.0–35.0) and during CT treatment 7.0 months (5.0–11.0) when assessed irrespective of treatment line (p=0.08). Patients who received at least one ALK TKI treatment regimen during the follow-up had median overall survival (OS) of 33.6 months (16.9–NR) from diagnosis vs. 11.5 months (4.6–NR) in patients who were treated with CT regimens only (p=0.054). Conclusions: ALK-positive patients benefit from treatment with ALK targeting agents in real-world clinical practice.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Treatment Patterns and Outcomes in a Cohort of Finnish NSCLC Patients with ALK Rearrangement Reflect Rapid Evolution in Treatment Practices
    AU  - Heidi Loponen
    AU  - Juuso Paajanen
    AU  - Ville Vihervaara
    AU  - Saija Ylä-Viteli
    AU  - Klaus Tamminen
    AU  - Saku Torvinen4
    AU  - Jari Jokelainen
    AU  - Tero Ylisaukko-oja
    AU  - Maria Silvoniemi
    Y1  - 2021/12/24
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijcems.20210706.16
    DO  - 10.11648/j.ijcems.20210706.16
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 200
    EP  - 209
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20210706.16
    AB  - Background: In Finland approximately 2,500 people are diagnosed with lung cancer annually. A small proportion of non-small cell lung cancer (NSCLC) patients (3–7%) have tumorigenic rearrangement of the anaplastic lymphoma kinase (ALK) gene (ALK-positive). ALK tyrosine kinase inhibitors (TKI) are the standard of care for these patients, showing superior efficacy compared to traditional chemotherapy (CT). Due to the rapid development of novel next-generation ALK TKIs, treatment practices have undergone substantial changes. In Finnish real-life clinical practice the choice of treatment is largely determined by the reimbursement status of available drugs. We set out to assess the prevailing treatment practices and outcomes for NSCLC patients harbouring ALK rearrangement. Materials and methods: This was a retrospective, non-interventional, two-centre study. Adult NSCLC patients from the Hospital District of Southwest Finland and ALK-positive NSCLC patients from the Hospital District of Helsinki and Uusimaa diagnosed between 2013–2017 were included. Patients were followed until death or until the end of study period (May 2018). Data were extracted retrospectively from electronic health records from University Hospital data lakes. Results: A total of 1,260 patients were included, of which 60 were ALK-positive. ALK TKI regimens were mainly received in second and later lines of treatment. Median time-to-next treatment (TTNT) during ALK TKI treatment was 11.0 months (95% CI; 5.0–35.0) and during CT treatment 7.0 months (5.0–11.0) when assessed irrespective of treatment line (p=0.08). Patients who received at least one ALK TKI treatment regimen during the follow-up had median overall survival (OS) of 33.6 months (16.9–NR) from diagnosis vs. 11.5 months (4.6–NR) in patients who were treated with CT regimens only (p=0.054). Conclusions: ALK-positive patients benefit from treatment with ALK targeting agents in real-world clinical practice.
    VL  - 7
    IS  - 6
    ER  - 

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Author Information
  • MedEngine Oy, Helsinki, Finland

  • Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland

  • Takeda Oy, Helsinki, Finland

  • Takeda Oy, Helsinki, Finland

  • Takeda Oy, Helsinki, Finland

  • MedEngine Oy, Helsinki, Finland

  • MedEngine Oy, Helsinki, Finland

  • Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland

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