Clinical outcomes of patients with resected, early-stage ALK-positive lung cancer

Lung Cancer : Journal of the International Association for the Study of Lung Cancer
Jamie ChaftJustin F Gainor

Abstract

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. 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). 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. In this large series of resected NSCLC, ALK rearrangements were associated with a trend toward inferior disease out...Continue Reading

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Citations

Feb 6, 2021·Journal of Cancer Research and Clinical Oncology·Yawei DouHongtao Wang
Nov 4, 2020·Annals of Surgical Oncology·In Ae KimKye Young Lee
Jun 15, 2021·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Zhengfu HeZhaonan Yu
Sep 29, 2019·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Chao ZhangWen-Zhao Zhong
Nov 3, 2020·The Journal of Thoracic and Cardiovascular Surgery·Yosuke MatsuuraMingyon Mun
Nov 10, 2020·The Journal of Thoracic and Cardiovascular Surgery·Staci Beamer, Jonathan D'Cunha

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