Effectiveness and prognostic factors of first-line crizotinib treatment in patients with ROS1-rearranged non-small cell lung cancer: A multicenter retrospective study

•First-line crizotinib treatment is beneficial in Chinese patients with ROS1-positive advanced NSCLC.•Involvement of more than two metastatic organs was an independent factor associated with shorter PFS.•G2032R mutation in the ROS1 kinase domain was the most common mechanism of resistance to crizoti...

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Veröffentlicht in:Lung cancer (Amsterdam, Netherlands) Netherlands), 2020-09, Vol.147, p.130-136
Hauptverfasser: Zheng, Jing, Cao, He, Li, Yuping, Rao, Chuangzhou, Zhang, Te, Luo, Jiayou, Lv, Dongqing, Zhu, Yanping, Zhou, Jianya, Zhou, Jianying
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container_start_page 130
container_title Lung cancer (Amsterdam, Netherlands)
container_volume 147
creator Zheng, Jing
Cao, He
Li, Yuping
Rao, Chuangzhou
Zhang, Te
Luo, Jiayou
Lv, Dongqing
Zhu, Yanping
Zhou, Jianya
Zhou, Jianying
description •First-line crizotinib treatment is beneficial in Chinese patients with ROS1-positive advanced NSCLC.•Involvement of more than two metastatic organs was an independent factor associated with shorter PFS.•G2032R mutation in the ROS1 kinase domain was the most common mechanism of resistance to crizotinib. ROS1 rearrangements are seen in 1–2 % of non-small cell lung cancer (NSCLC) patients. The aim of this study was to determine the effectiveness of crizotinib as first-line treatment in patients with ROS1 rearranged NSCLC. The data of 56 patients with ROS1-rearranged advanced NSCLC who received first-line crizotinib treatment from 5 hospitals in China were retrospectively reviewed. The clinical characteristics, outcomes of first-line crizotinib therapy and prognostic factors were evaluated. In addition, mechanisms of resistance to crizotinib were analyzed in a cohort of crizotinib-resistant patients. The median age of the cohort was 53.0 years and most patients (91.1 %) had adenocarcinomas. The median progression free survival (mPFS) after first-line crizotinib therapy was 23.0 months, and the median overall survival (mOS) was 60.0 months. In the univariate analysis, mPFS was significantly shorter in female patients compared to males (12.0 months versus 24.0 months; p = 0.015) and in patients with >2 baseline metastatic organ involvement compared to those with ≤2 baseline metastatic organ involvement (4.0 months vs 24.0 months; p < 0.001).In addition, the mOS was significantly shorter in patients with >2 baseline metastatic organ involvement relative to that in patients with ≤2 baseline metastatic organ involvement (6.0 months vs 60.0 months; p < 0.001). Multivariable analysis further showed that >2 baseline metastatic organ involvement was the only independent prognostic factor of PFS (p = 0.008). Four out of 8 patients (50 %) with crizotinib resistance harbored a G2032R mutation in the ROS1 kinase domain. First-line crizotinib treatment is beneficial in Chinese patients with ROS1-rearranged advanced NSCLC. Resistance to crizotinib correlated with the G2032R mutation in the ROS1 kinase domain.
doi_str_mv 10.1016/j.lungcan.2020.07.016
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ROS1 rearrangements are seen in 1–2 % of non-small cell lung cancer (NSCLC) patients. The aim of this study was to determine the effectiveness of crizotinib as first-line treatment in patients with ROS1 rearranged NSCLC. The data of 56 patients with ROS1-rearranged advanced NSCLC who received first-line crizotinib treatment from 5 hospitals in China were retrospectively reviewed. The clinical characteristics, outcomes of first-line crizotinib therapy and prognostic factors were evaluated. In addition, mechanisms of resistance to crizotinib were analyzed in a cohort of crizotinib-resistant patients. The median age of the cohort was 53.0 years and most patients (91.1 %) had adenocarcinomas. The median progression free survival (mPFS) after first-line crizotinib therapy was 23.0 months, and the median overall survival (mOS) was 60.0 months. In the univariate analysis, mPFS was significantly shorter in female patients compared to males (12.0 months versus 24.0 months; p = 0.015) and in patients with &gt;2 baseline metastatic organ involvement compared to those with ≤2 baseline metastatic organ involvement (4.0 months vs 24.0 months; p &lt; 0.001).In addition, the mOS was significantly shorter in patients with &gt;2 baseline metastatic organ involvement relative to that in patients with ≤2 baseline metastatic organ involvement (6.0 months vs 60.0 months; p &lt; 0.001). Multivariable analysis further showed that &gt;2 baseline metastatic organ involvement was the only independent prognostic factor of PFS (p = 0.008). Four out of 8 patients (50 %) with crizotinib resistance harbored a G2032R mutation in the ROS1 kinase domain. First-line crizotinib treatment is beneficial in Chinese patients with ROS1-rearranged advanced NSCLC. 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ROS1 rearrangements are seen in 1–2 % of non-small cell lung cancer (NSCLC) patients. The aim of this study was to determine the effectiveness of crizotinib as first-line treatment in patients with ROS1 rearranged NSCLC. The data of 56 patients with ROS1-rearranged advanced NSCLC who received first-line crizotinib treatment from 5 hospitals in China were retrospectively reviewed. The clinical characteristics, outcomes of first-line crizotinib therapy and prognostic factors were evaluated. In addition, mechanisms of resistance to crizotinib were analyzed in a cohort of crizotinib-resistant patients. The median age of the cohort was 53.0 years and most patients (91.1 %) had adenocarcinomas. The median progression free survival (mPFS) after first-line crizotinib therapy was 23.0 months, and the median overall survival (mOS) was 60.0 months. In the univariate analysis, mPFS was significantly shorter in female patients compared to males (12.0 months versus 24.0 months; p = 0.015) and in patients with &gt;2 baseline metastatic organ involvement compared to those with ≤2 baseline metastatic organ involvement (4.0 months vs 24.0 months; p &lt; 0.001).In addition, the mOS was significantly shorter in patients with &gt;2 baseline metastatic organ involvement relative to that in patients with ≤2 baseline metastatic organ involvement (6.0 months vs 60.0 months; p &lt; 0.001). Multivariable analysis further showed that &gt;2 baseline metastatic organ involvement was the only independent prognostic factor of PFS (p = 0.008). Four out of 8 patients (50 %) with crizotinib resistance harbored a G2032R mutation in the ROS1 kinase domain. First-line crizotinib treatment is beneficial in Chinese patients with ROS1-rearranged advanced NSCLC. Resistance to crizotinib correlated with the G2032R mutation in the ROS1 kinase domain.</description><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - genetics</subject><subject>China</subject><subject>Crizotinib</subject><subject>Crizotinib - therapeutic use</subject><subject>Effectiveness</subject><subject>Female</subject><subject>First-line treatment</subject><subject>Humans</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - genetics</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Non-small cell lung cancer</subject><subject>Prognosis</subject><subject>Prognostic factors</subject><subject>Protein Kinase Inhibitors - therapeutic use</subject><subject>Protein-Tyrosine Kinases - genetics</subject><subject>Proto-Oncogene Proteins - genetics</subject><subject>Resistance mechanisms</subject><subject>Retrospective Studies</subject><issn>0169-5002</issn><issn>1872-8332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUcuOFCEUJUbjtKOfoLlLN1UC9YByYyaT8ZFMMomPNaHhVkunimqBGjN-kN_p7XTrVhY8DudwD_cw9lLwWnDRv9nX0xp3zsZacslrrmpCH7GN0EpWumnkY7YhZKg6zuUFe5bznnOhBB-esotGKi67ftiw3zfjiK6Ee4yYM9jo4ZCWXVxyCQ5G68qSMiwjjCHlUk0hIrgUfi0lxLCFktCWGWOBEOFgS6Bthp-hfIfPd19ERdcp2bhDD3GJVZ7tNIFDmo7ugew7TG_hCuZ1ooKkxgQJS1ry4WQLcln9w3P2ZLRTxhfn9ZJ9e3_z9fpjdXv34dP11W3lmr4rVb8V2A_Sox4Gia2ksx96gV5LlFZv0SklnVXWNUpq23Lddl7aXvQ0LKGX7PXpXWrCjxVzMXPIR7824rJmI1upGt61WhO1O1Edmc0JR3NIYbbpwQhujhGZvTlHZI4RGa4MoaR7dS6xbmf0_1R_MyHCuxMB6aP3AZPJjvrq0IdEPTF-Cf8p8QdLVqlw</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Zheng, Jing</creator><creator>Cao, He</creator><creator>Li, Yuping</creator><creator>Rao, Chuangzhou</creator><creator>Zhang, Te</creator><creator>Luo, Jiayou</creator><creator>Lv, Dongqing</creator><creator>Zhu, Yanping</creator><creator>Zhou, Jianya</creator><creator>Zhou, Jianying</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202009</creationdate><title>Effectiveness and prognostic factors of first-line crizotinib treatment in patients with ROS1-rearranged non-small cell lung cancer: A multicenter retrospective study</title><author>Zheng, Jing ; 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ROS1 rearrangements are seen in 1–2 % of non-small cell lung cancer (NSCLC) patients. The aim of this study was to determine the effectiveness of crizotinib as first-line treatment in patients with ROS1 rearranged NSCLC. The data of 56 patients with ROS1-rearranged advanced NSCLC who received first-line crizotinib treatment from 5 hospitals in China were retrospectively reviewed. The clinical characteristics, outcomes of first-line crizotinib therapy and prognostic factors were evaluated. In addition, mechanisms of resistance to crizotinib were analyzed in a cohort of crizotinib-resistant patients. The median age of the cohort was 53.0 years and most patients (91.1 %) had adenocarcinomas. The median progression free survival (mPFS) after first-line crizotinib therapy was 23.0 months, and the median overall survival (mOS) was 60.0 months. In the univariate analysis, mPFS was significantly shorter in female patients compared to males (12.0 months versus 24.0 months; p = 0.015) and in patients with &gt;2 baseline metastatic organ involvement compared to those with ≤2 baseline metastatic organ involvement (4.0 months vs 24.0 months; p &lt; 0.001).In addition, the mOS was significantly shorter in patients with &gt;2 baseline metastatic organ involvement relative to that in patients with ≤2 baseline metastatic organ involvement (6.0 months vs 60.0 months; p &lt; 0.001). Multivariable analysis further showed that &gt;2 baseline metastatic organ involvement was the only independent prognostic factor of PFS (p = 0.008). Four out of 8 patients (50 %) with crizotinib resistance harbored a G2032R mutation in the ROS1 kinase domain. First-line crizotinib treatment is beneficial in Chinese patients with ROS1-rearranged advanced NSCLC. Resistance to crizotinib correlated with the G2032R mutation in the ROS1 kinase domain.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>32702569</pmid><doi>10.1016/j.lungcan.2020.07.016</doi><tpages>7</tpages></addata></record>
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subjects Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - genetics
China
Crizotinib
Crizotinib - therapeutic use
Effectiveness
Female
First-line treatment
Humans
Lung Neoplasms - drug therapy
Lung Neoplasms - genetics
Male
Middle Aged
Non-small cell lung cancer
Prognosis
Prognostic factors
Protein Kinase Inhibitors - therapeutic use
Protein-Tyrosine Kinases - genetics
Proto-Oncogene Proteins - genetics
Resistance mechanisms
Retrospective Studies
title Effectiveness and prognostic factors of first-line crizotinib treatment in patients with ROS1-rearranged non-small cell lung cancer: A multicenter retrospective study
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