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- Renaud Descourt, Maurice Perol, Gaëlle Rousseau-Bussac, David Planchard, Bertrand Mennecier, Marie Wislez, Alexis Cortot, Florian Guisier, Loïck Galland, Pascal Dô, Roland Schott, Eric Dansin, Jennifer Arrondeau, Jean-Bernard Auliac, and Christos Chouaid.
- Centre Hospitalier Universitaire, Oncology Department, Brest, France. Electronic address: renaud.descourt@chu-brest.fr.
- Lung Cancer. 2019 Oct 1; 136: 109-114.
ObjectivesBrigatinib is a next-generation ALK inhibitor initially developed in ALK-positive NSCLC pretreated with crizotinib.Materials And MethodsThis retrospective multicentric study analyzed ALK-positive advanced NSCLC patients pretreated with at least one tyrosine-kinase inhibitor, including crizotinib, and enrolled in the brigatinib French early access program. The primary endpoint was investigator-assessed progression-free survival (PFS).Results104 patients were included (mean age, 56.6 years; never smokers, 61.5%; adenocarcinoma, 98.1%). Patients had received a median of 3 previous treatment lines, including at least 2 ALK inhibitors (mainly crizotinib then ceritinib). At brigatinib initiation, 59.1% had performance status 0-1, 51.9% had ≥ 3 metastatic sites, 74.5% had central nervous system metastases (CNS) and 8.8% had carcinomatous meningitis. Median duration of brigatinib treatment was 6.7 (95% CI, 0.06-20.7) months. Median PFS was 6.6 (4.8-9.9) months for the entire population. For patients who received 2, 3-4 and >4 lines of treatment before brigatinib, PFS was 4.3 (2.5-8.9), 10.4 (5.9-13.9) and 3.8 (0.8-7.4) months, respectively. In the 91 evaluable patients, disease control rate was 78.2%. From brigatinib start, median overall survival was 17.2 (11.0-not reached) months. Among the 68 patients with progressive disease after brigatinib, CNS was involved in 29.4% of cases. Median OS from the diagnosis of NSCLC was 75.3 (38.2-174.6) months.ConclusionThese real-world results confirm the efficacy of brigatinib in a cohort of patients heavily pretreated for ALK-positive advanced NSCLC.Copyright © 2019 Elsevier B.V. All rights reserved.
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