ALK Fusions Associated with Better Prognosis in Advanced NSCLC

By Robert Dillard - Last Updated: January 4, 2021

A study published in Frontiers in Oncology found that some patients with non-small cell lung cancer (NSCLC) may experience better outcomes with anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs).

In this retrospective study, researchers assessed crizotinib treatment response in 98 ALK-positive patients with advanced NSCLC. All patients were partitioned into different groups based on ALK fusion patterns using Comprehensive genomic profiling (CGP).

The findings showed that over 54% of patients had pure canonical EML4-ALK fusions, 19.4% carried only non-canonical ALK fusions, and 26.5% harbored complex ALK fusions with coexisting canonical and non-canonical ALK fusions. The researchers observed that the objective response rate and median progression-free survival to crizotinib treatment were better in the complex ALK fusion group. Notably, the researchers observed patients with complex ALK fusions exhibited marked improvement in overall survival following crizotinib treatment (P=0.012), especially when compared with the pure canonical EML4-ALK fusion group (P=0.010). Moreover, the results showed that complex ALK fusion group also tended to respond better to next-generation ALK TKIs.

“Our results suggest NSCLC patients with complex ALK fusions could potentially have better treatment outcomes to ALK TKIs therapy,” the researchers concluded. They added that, “diagnosis using CGP is of great value to identify novel ALK fusions and predict prognosis.”