Safety and Efficacy of Alectinib in the First Line for ALK-Mutated Lung Cancer: A Real-World Data from India

• DOI: 10.1055/s-0045-1806811
• Publication Date: 2025-04-03T23:36:24Z
• Authors: Ajaykumar Singh; Vanita Noronha; Vijay Patil; Nandini Menon; Akhil Kapoor; Mehak Trikha; Sima Manmode; Rajiv Kaushal; Trupti Pai; Nilendu Purandare; Amit Janu; Anuradha Majumdar; Ahmad Ashfaq Ahma...; Kumar Prabhash
• Keywords: Alectinib; Real world data

Abstract Advanced/metastatic ALK-mutated lung cancer has excellent long-term survival due availability of multiple targeted drugs. Alectinib is one the preferred first-line therapies based on Alex trial data. We present a real-world outcome with alectinib in setting low- and middle-income country (LMIC) like India. conducted retrospective audit ALK positive patients who received at Medical Oncology Department, Tata Memorial Hospital, Mumbai, Maharashtra, included were started between January 2018 March 2022. The underwent routine blood radiological evaluation every 2 to 3 months. analyzed data for progression-free (PFS), overall (OS), safety profile. A total 50 specified period. median age was 52.5 years (range: 28–81 years), 72% 60 or less; 54% being male 46% female. Eastern Cooperative Group-Performance Status (PS) 0 1 70%, PS 24%, ¾ 6%. Methods testing immunohistochemistry 92%, fluorescence situ hybridization 2%, next-generation sequencing most common sites metastasis before starting bone (52%), pleura (42%), brain (30%), (28%). Note that 66 33% radiotherapy bone-modifying agent central nervous system metastasis, respectively. follow-up period 18 months (13.1–22.8 months). Objective response rate 76%, partial 74%, complete 4%, stable disease 16%. Median PFS OS not reached, yet expected 3-year 69.3% 85.7%, progression liver. Majority side effects grade only anemia, patient had effect (anemia). No drug interruption dose modifications needed any patient. This from LMIC confirm efficacy matching registration studies similar tolerance, without new alarm.