In a nutshell
This study investigated the safety and effectiveness of crizotinib (Xalkori) in advanced non-small cell lung cancer (NSCLC). They found that this treatment improved survival in advanced NSCLC.
Standard therapy for NSCLC involves chemotherapy and radiation. Patients with advanced NSCLC may not respond to standard therapy. Targeted therapies may be more effective. These target specific proteins or growth factors. They can also target genetic abnormalities. ROS1 rearrangements (RRAs) are found in 1-2% of NSCLC. RRAs change the position of ROS1 on the chromosome. This leads to an increase in cancer cell growth.
Crizotinib is a drug that targets ROS1. It is a tyrosine kinase inhibitor (TKI). Crizotinib treatment reduced tumor progression in a small number of patients. It is unclear if crizotinib treatment improves survival in NSCLC.
Methods & findings
This study included 53 patients with advanced NSCLC. All patients had ROS1 RRAs. Crizotinib was taken orally twice daily. The total daily dose was 500mg. Tumor progression was measured every 6-8 weeks. Patients were followed up for an average of 62.6 months.
The overall response rate was 72% in patients treated with crizotinib. The response to treatment was rapid and was maintained for an average of 24.7 months. 68% of patients died or had disease progression during the trial.
Survival without cancer progression was 19.3 months on average. The average overall survival was 51.4 months. The probability for overall survival at 2 years was 67%/ This probability at 4 years was 51%.
Treatment-related side effects were reported in all patients. They were mild to moderate in severity. They incuded vision disorder, nausea, vomiting, and diarrhea.
The bottom line
The authors concluded that crizotinib improved survival in advanced NSCLC.
The fine print
This was a single-arm study. Crizotinib was not compared to an alternative treatment or standard therapy. A small number of patients survived until the end of the study. More investigation is needed.
Published By :
Annals of oncology: official journal of the European Society for Medical Oncology
Apr 13, 2019