(HealthDay News) — For patients with chromosomal rearrangements of the anaplastic lymphoma kinase gene (ALK), treatment with an oral tyrosine kinase inhibitor targeting ALK, crizotinib, is superior to standard chemotherapy, according to a study published online June 1 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Society of Clinical Oncology, held from May 31 to June 4 in Chicago.
Alice T. Shaw, M.D., Ph.D., from Massachusetts General Hospital in Boston, and colleagues conducted a phase 3, open-label trial involving 347 patients with locally advanced or metastatic ALK-positive lung cancer who had received one prior platinum-based regimen. Patients were randomized to receive crizotinib or intravenous chemotherapy with pemetrexed or docetaxel every three weeks. As part of a separate study, patients from the chemotherapy group who experienced disease progression were allowed to cross over to crizotinib.
The researchers found that the median progression-free survival was significantly longer in the crizotinib group than the chemotherapy group (7.7 versus 3.0 months; hazard ratio for progression or death, 0.49). The response rates were significantly higher with crizotinib than with chemotherapy (65 versus 20 percent). An interim analysis showed that there was no significant improvement in overall survival with crizotinib versus chemotherapy (hazard ratio, 1.02; P = 0.54). Compared with chemotherapy, patients treated with crizotinib reported greater reductions in lung cancer symptoms and greater improvement in global quality of life.
“Crizotinib is superior to standard chemotherapy in patients with previously treated, advanced non-small-cell lung cancer with ALK rearrangement,” the authors write.
The study was funded by Pfizer, the manufacturer of crizotinib.