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Non-Small-Cell Lung Cancer (NSCLC) Harboring ALK Translocations: Clinical Characteristics and Management in a Real-Life Setting: a French Retrospective Analysis (GFPC 02–14 Study)

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Abstract

Background

Chromosomal translocations involving the anaplastic lymphoma kinase gene (ALK) are rare oncogenic events found in 3–5% of non-small-cell lung cancers (NSCLC). Limited data have been published on the management of these patients outside clinical trials.

Objective

To investigate the clinical characteristics and management of patients with NSCLC harboring ALK translocations (ALK+) in a real-life setting in France.

Methods

This multicenter, observational, retrospective study included all NSCLC patients harboring ALK translocations diagnosed in participating centers between January 2012 and December 2014. Patient data include clinical characteristics, disease management, and outcomes [progression-free survival (PFS) and overall survival (OS)].

Results

The 31 participating centers reported data on 132 patients, of whom 51% (n = 67) were male. The median age was 60.1 ± 14.5 (standard deviation) years; 89% (n = 106/119) had performance status 0/1 at diagnosis; 79% (n = 103/130) were non- or former smokers; 93% (n = 120/129) had adenocarcinomas and 74%(n = 97)/19%(n = 25)/7%(n = 10) had disease stages IV/III/I-II at diagnosis, respectively; co-mutations included EGFR (n = 2), BRAF (n  = 2), KRAS (n = 1), and HER2 (n = 1). Of the patients with stage IV NSCLC (n = 97), 96% received first-line treatment [75% chemotherapy-based, 21% ALK tyrosine kinase inhibitor (TKI)], with an associated response rate (RR), disease-control rate (DCR), and PFS of 42%, 64%, and 7.5 [95% confidence interval (CI) 5.9–9.5] months, respectively; 62% received second-line treatment (28% chemotherapy, 72% ALK TKI) with an associated RR, DCR, and PFS of 43.4%, 70%, and 4.7 (95% CI 4.0–8.1) months, respectively. The 2-year OS was 56.7% (95% CI 45.5–70.4%); median OS was not reached.

Conclusion

The results of this real-life analysis suggest that the prognosis of NSCLC patients with theALK translocation may be better than that of the overall NSCLC population, but the outcomes were poorer than those of ALK+ NSCLC patients included in clinical studies.

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Authors and Affiliations

  1. Service de Pneumologie et Oncologie Thoracique, Center Hospitalier (CH) François Quesnay, 2, Boulevard de Sully, 78200, Mantes-la-Jolie, France

    Jean-Bernard Auliac

  2. Centre Hospitalier Intercommunal de Créteil (CHI), Créteil, France

    Isabelle Monnet & Christos Chouaid

  3. CAC Caen, Caen, France

    Catherine Dubos-Arvis

  4. CH Quimper, Quimper, France

    Anne Marie Chiappa

  5. Le Centre Hospitalier Universitaire (CHU) Angers, Angers, France

    Nathalie Baize

  6. CHU Rouen, Rouen, France

    Suzana Bota

  7. CHU Limoges, Limoges, France

    Alain Vergnenegre

  8. CH Suresnes, Suresnes, France

    Helene Doubre

  9. CH Meaux, Meaux, France

    Chrystele Locher

  10. CH La Roche-sur-Yon, La Roche-sur-Yon, France

    Acya Bizieux

  11. CHU Brest, Brest, France

    Gilles Robinet

Authors
  1. Jean-Bernard Auliac
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  2. Isabelle Monnet
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  7. Alain Vergnenegre
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  8. Helene Doubre
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  11. Gilles Robinet
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  12. Christos Chouaid
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Corresponding author

Correspondence to Jean-Bernard Auliac.

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Funding

The study was supported by academic grants from Lilly, Astra Zeneca, and Boehringer Ingelheim. The sponsors played no role in the design or performance of the study, data analysis, or manuscript preparation. The results belong to Groupe Français d’Oncologie Thoracique (GFPC). The data were analyzed by the GFPC statistician and interpreted by the authors.

Conflict of Interest

Jean-Bernard Auliac has received honoraria for attending scientific meetings, speaking, organizing research, or consulting from Boehringer Ingelheim, Hoffman-Roche, Lilly, and Pfizer. Helene Doubre has received honoraria for consulting from Novartis, AstraZeneca, BMS, MSD, and Boehringer Ingelheim. Christos Chouaid has received honoraria for attending scientific meetings, speaking, organizing research, or consulting from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Hoffman-Roche, Sanofi Aventis, Lilly, Novartis, and Amgen. All other authors declare no conflict of interest.

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Auliac, JB., Monnet, I., Dubos-Arvis, C. et al. Non-Small-Cell Lung Cancer (NSCLC) Harboring ALK Translocations: Clinical Characteristics and Management in a Real-Life Setting: a French Retrospective Analysis (GFPC 02–14 Study). Targ Oncol 12, 833–838 (2017). https://doi.org/10.1007/s11523-017-0520-7

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  • DOI: https://doi.org/10.1007/s11523-017-0520-7

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