38P Real-world treatment patterns and effectiveness of subsequent treatments following first-line (1L) brigatinib for patients with anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) from ALTA-1L

• DOI: 10.1016/j.esmoop.2024.102617
• Publication Date: 2024-03-25T08:43:46Z
• Authors: A. Delmonte; M-J. Ahn; S. Ghosh; M.J. Hochmair; T-Y. Yang; J.C-H. Yang; J-Y. Han; K.H. Holmskov; Y. Wu; Y. Wan; M. Lin; J. Kretz; B. Hupf; A.M. Kurec; E. Churchill; R. Fram; C.J. Cabasag; V. Goriya; Y. Zhao; M.R. García Campelo
• Keywords: ALK inhibitor; First line treatment; Ceritinib

Brigatinib, an ALK tyrosine kinase inhibitor (TKI), showed superior clinical efficacy in 1L for ALK+ NSCLC compared to crizotinib the phase III ALTA-1L trial. There is a lack of data on real-world treatment patterns and outcomes post-1L brigatinib. This non-interventional, multicenter, retrospective chart review study included patients with previously enrolled brigatinib arm ALTA-1L. Patients who discontinued (index event) were followed from last dose Time discontinuation (TTD), progression-free survival (PFS) 2L therapy, time randomization date disease progression therapy or death (PFS2), overall (OS) estimated using Kaplan-Meier methods. As Oct 18, 2023, 48 (median age=58 years; male=45.8%; White=43.8%; Asian=54.2%) median follow-up 12.4 months. 40 (83.3%) had received subsequent systemic anticancer therapies. Of these, 30 (75%) TKIs: 16 (53%) lorlatinib, 8 (27%) alectinib, 6 (20%) crizotinib. Overall response rate control TKIs 33.3% 70.8%, respectively, lorlatinib 30.8% 76.9%, respectively. Median PFS (95% CI) was 16.1 (4.4, NR) months 24-month 47% (26.2, 65.3) TKIs, while 25.6 (3.8, 53.4% (23.9, 76.0) lorlatinib. Please see Table TTD, PFS, PFS2, OS 2L.Table: 38PTTD, TKIsOutcome CI)2L (n=30)2L (n=16)mTTD, mo34.7 (4.6, NR)37.2 (6.0, NR)Receiving at 24 mo, %53.1 (32.2, 70.2)68.1 (35.4, 86.8)mPFS, mo16.1 NR)25.6 NR)24-mo %47 65.3)53.4 76.0)mPFS2, mo51.6 (25.9, NR)74.7 %78.4 (58.1, 89.7)86.7 (56.4, 96.5)mOS, mo74.7 (30.0, NR)36-mo OS, %66.7 (46.9, 80.5)75.0 (46.3, 89.8)2L, second line; ALK, anaplastic lymphoma kinase; CI, confidence interval; month; mOS, survival; mPFS, mTTD, discontinuation; NR, not reached; TKI, inhibitor. Open table new tab 2L, Most started another TKI after discontinuing offered benefit brigatinib, suggesting effective choice by other including