Efficacy of Crizotinib, Ceritinib, and Alectinib in ALK-Positive Non-Small Cell Lung Cancer Treatment: A Meta-Analysis of Clinical Trials

Hoang, Tung; Myung, Seung‐Kwon; Pham, Thu Thi; Park, Boyoung

doi:10.3390/cancers12030526

Cited by 19 publications

(10 citation statements)

References 33 publications

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“…Consequently, it is not possible with our study design to affirm whether there is any real benefit of using crizotinib in improving OS in this patient population. The finding results are aligned with other systematic reviews and meta-analyzes identified during the literature search [27][28][29][30][31][32][33].…”

Section: Discussionsupporting

confidence: 80%

“…Consequently, we wanted to provide baseline data for any subsequent evaluation of therapies for NSCLC patients with [26]. We believe this is the first systematic review and meta-analysis to summarize the scientific evidence on the use of this drug exclusively in the first line of treatment for NSCLC ALK?, building on previous publications [27][28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

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Crizotinib Versus Conventional Chemotherapy in First-Line Treatment for ALK-Positive Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Cruz

Barbosa²,

Tôrres

et al. 2021

Oncol Ther

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Introduction: Lung cancer is the most frequently diagnosed type of cancer and the main cause of death from malignant neoplasms worldwide. One of the most recent discoveries in the context of non-small cell lung cancer (NSCLC) was the mutation of the anaplastic lymphoma kinase receptor (ALK). This genetic alteration is found in approximately 2-5% of NSCLC patients, and crizotinib was the first targeted therapy discovered for its first-line treatment.Objective: To conduct a systematic review and meta-analysis to estimate the magnitude of the overall survival (OS) and progression-free survival (PFS) from using crizotinib as treatment compared to traditional chemotherapy to guide future decision making. Methods: PRISMA and Cochrane recommendations were followed using the findings based on studies published in the main international electronic databases. Selection criteria included the following: randomized clinical trials (RCT) or cohort studies that had assessed the efficacy and effectiveness of crizotinib as monotherapy in patients with NSCLC with ALK fusions. Results: From 2504 publications identified in the literature, only eight publications referring to seven studies met the selection criteria, with high heterogeneity identified between the studies. Overall, there was a significant gain in PFS (HR 0.38; 95% CI 0.30-0.49; p \ 0.00001); however, there was no significant gain in OS (HR 0.68; 95% CI 0.43-1.08; p = 0.10). Conclusion:The study highlighted and confirmed that treatment with crizotinib led to clinical improvement in PFS among patients with advanced NSCLC with ALK fusion, as previously reported. However, there was no increase in overall survival in patients with NSCLC with genetic alterations of ALK. This must be considered when reviewing and funding treatments for NSCLC patients with this

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Crizotinib Versus Conventional Chemotherapy in First-Line Treatment for ALK-Positive Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Cruz

Barbosa²,

Tôrres

et al. 2021

Oncol Ther

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“…Although ceritinib is also a second-generation ALK inhibitor, our study showed that there is no signicant difference in the efficacy between ceritinib and crizotinib. Similarly, the recent meta-analyses of pooled estimates reported that crizotinib might have higher ORR [66% (58-74%) vs. 52% (38-66%)] and longer PFS [9.27 months (8.28-10.26) vs. 5.92 months (4.36-7.48)] than ceritinib, although no statistical test was performed [26]. It remains unclear why ceritinib did not show a superior efficacy unlike alectinib.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Comparative Efficacy of Targeted Therapies in Patients with Non-Small Cell Lung Cancer: A Network Meta-Analysis of Clinical Trials

Hoang

Myung

Pham

et al. 2020

JCM

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This study aims to investigate the efficacy of targeted therapies in the treatment of non-small cell lung cancer (NSCLC) by using a network meta-analysis of clinical trials. PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov were searched by using keywords related to the topic on 19 September 2018. Two investigators independently selected relevant trials by pre-determined criteria. A pooled response ratio (RR) for overall response rate (ORR) and a hazard ratio (HR) for progression-free survival (PFS) were calculated based on both the Bayesian and frequentist approaches. A total of 128 clinical trials with 39,501 participants were included in the final analysis of 14 therapeutic groups. Compared with chemotherapy, both ORR and PFS were significantly improved for afatinib, alectinib, and crizotinib, while only PFS was significantly improved for cabozantinib, ceritinib, gefitinib, and osimertinib. Consistency was observed between the direct and indirect comparisons based on the Bayesian approach statistically and the frequentist approach visually. Cabozantinib and alectinib showed the highest probability for the first-line treatment ranking in ORR (62.5%) and PFS (87.5%), respectively. The current network meta-analysis showed the comprehensive evidence-based comparative efficacy of different types of targeted therapies, which would help clinicians use targeted therapies in clinical practice.

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“…Crizotinib, an oral ALK/MET/ROS1 inhibitor, prompted the development of ALK target therapy[ 90 ]. It became the first ALK inhibitor to be approved by the FDA for standard first-line therapy in patients with ALK-positive NSCLC.…”

Section: Closing Remarks and Future Perspectivementioning

confidence: 99%

Molecular-targeted therapy toward precision medicine for gastrointestinal caner: Current progress and challenges

Matsuoka¹,

Yashiro²

2021

WJGO

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Gastrointestinal (GI) cancer remains the deadliest cancer in the world. The current standard treatment for GI cancer focuses on 5-fluorouracil-based chemotherapeutic regimens and surgery, and molecular-targeted therapy is expected to be a more effective and less toxic therapeutic strategy for GI cancer. There is well-established evidence for the use of epidermal growth factor receptor-targeted and vascular endothelial growth factor-targeted antibodies, which should routinely be incorporated into treatment strategies for GI cancer. Other potential therapeutic targets involve the PI3K/AKT pathway, tumor growth factor-β pathway, mesenchymal-epithelial transition pathway, WNT pathway, poly (ADP-ribose) polymerase, and immune checkpoints. Many clinical trials assessing the agents of targeted therapy are underway and have presented promising and thought-provoking results. With the development of molecular biology techniques, we can identify more targetable molecular alterations in larger patient populations with GI cancer. Targeting these molecules will allow us to reach the goal of precision medicine and improve the outcomes of patients with GI cancer.

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Efficacy of Crizotinib, Ceritinib, and Alectinib in ALK-Positive Non-Small Cell Lung Cancer Treatment: A Meta-Analysis of Clinical Trials

Cited by 19 publications

References 33 publications

Crizotinib Versus Conventional Chemotherapy in First-Line Treatment for ALK-Positive Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Crizotinib Versus Conventional Chemotherapy in First-Line Treatment for ALK-Positive Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Comparative Efficacy of Targeted Therapies in Patients with Non-Small Cell Lung Cancer: A Network Meta-Analysis of Clinical Trials

Molecular-targeted therapy toward precision medicine for gastrointestinal caner: Current progress and challenges

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