克唑替尼治疗晚期NSCLC患者单中心回顾性分析

BACKGROUND AND OBJECTIVE: Crizotinib was developed in recent years based on targets of anaplastic lymphoma kinase (ALK) fusion genes. The aim of this study is to explore the efficacy of crizotinib in treatment of non-small cell lung cancer (NSCLC) with ALK/ROS1 rearrangement. METHODS: Retrospective analysis of 40 patients with ALK/ROS1-positive NSCLC, who received treatment in Beijing Cancer Hospital during the period from Jun. 2013 to Dec. 2014. RESULTS: Among these cases, 39 were adenocarcinoma and adenosquamous carcinoma, with characters involving signet-ring cell carcinoma, polypoid adenocarcinoma, acini and papillary adenocarcinoma. The median age was 49.5 years old, with the overall response rate of 62.5% and disease control rate of 95.0%. Of all the cases, median follow-up was 14.6 months and median PFS 7.5 months; median OS has not been reached; the one-year survival rate was 77.4%. The median PFS and OS of patients receiving first and second-line treatment tend to be longer than those who received post-second line treatment, but with no statistical significance (PFS: 9 mo vs 6 mo, P=0.06; OS: 21.5 mo vs 14.6 mo, P=0.12). Twenty patients who experienced progression in brain metastases. After experiencing progression, the patients receiving 2(nd)/3(rd) generation ALK-TKI treatment showed efficacy of disease control and survival. The adverse events include gastrointestinal reaction, transaminase elevation, and distinctive visual abnormalities, etc. CONCLUSION: The clinical features, efficacy, and adverse events of crizotinib in the treatment of the 40 patients with ALK/ROS1-positive NSCLC are similar to the data from the previous reports. The most common site of progression was brain metastases. The treatment of crizotinib-resistant patients using 2(nd)/3(rd) generation ALK-TKI could delay progression.