Real-World Outcomes in Anaplastic Lymphoma Kinase–Positive Advanced Non–Small Cell Lung Cancer in Argentina: A Multicenter Retrospective Study (GAOT-ALK001)
Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE In Argentina, anaplastic lymphoma kinase (ALK) gene rearrangements occur in approximately 6.1% of non–small cell lung cancer (NSCLC) cases. Given the availability of second- and third-generation ALK inhibitors, real-world data are needed to inform optimal treatment strategies. However, access to these therapies remains limited for many patients. METHODS We conducted a multicenter retrospective study of patients with metastatic ALK-positive NSCLC (ALKp) treated with first-line tyrosine kinase inhibitors (TKIs) from January 2014 to February 2024. Demographics, treatment patterns, clinical outcomes, and factors affecting treatment accessibility were analyzed. RESULTS We identified 104 patients with ALKp. The median age was 55 years (IQR, 45-67); 86% had Eastern Cooperative Oncology Group ≤1, 58% were women, and 57% were nonsmokers. Brain metastases were present at diagnosis in 29%, with 50% receiving local treatment. First-line TKIs included alectinib (42%), crizotinib (30%), lorlatinib (16%), and brigatinib (12%). Crizotinib use was frequently due to limited access to new-generation TKIs. Adverse events occurred in 54%, with 21% grade 3 to 4. The objective response rate was 73%. At a median follow-up of 42 months, 48% experienced progression. Crizotinib was associated with higher risk of progression or death compared with newer TKIs (hazard ratio, 3.09 [95% CI, 1.75 to 5.5]; P = .01). CNS progression occurred in 18%, more often with crizotinib (42% v 8%, P = .04). Among those progressing, 82% received second-line therapy, most commonly lorlatinib or alectinib. The overall survival at 24 months was 81%, with 27% of patients deceased at data cutoff. CONCLUSION This real-world study describes outcomes and treatment patterns among patients with ALKp in Argentina. It highlights disparities in access to optimal therapies and reinforces the need for equitable access to new-generation ALK inhibitors to improve clinical outcomes.
Source: JCO Global Oncology
DOI: 10.1200/go-25-00014
Authors: Luis Basbus, Maite Queral, Delfina Peralta Tanco, Mara Bonet, Patricio Levit, Gabriela Malcervelli, Carlos Brocca, Susana Sena, Vanina Wainsztein, Diego Kaen, Sebastian Cinquini, Manglio Rizzo, Nicolas Castagneris, Enrique Aman, Gonzalo Di Mario, Richard Serna, Florencia Tsou, Ivan Macharashvili, Yamila Ferreira, Diego Enrico, Carmen Pupareli, Ignacio Robledo Salas, Florencia Guerra, Carlos Picón, Danisa Fariña, Cintia Novas, Rosario Pasquinelli, Aldo Perfetti, Lorena Lupinacci, Claudio Martin, GAOT Group
Institutions: Hospital Italiano de Buenos Aires, Instituto Alexander Fleming, Hospital Privado, Hospital Alemán, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Hospital Británico de Buenos Aires, Hospital Universitario Austral, Swissmedic, Hospital César Milstein, Hospital Fernández
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,472
OpenAlex ID: W4414830181