Efficacy of ALK inhibitors in Asian patients with ALK inhibitor-naïve advanced ALK-positive non-small cell lung cancer: a systematic review and network meta-analysis.

IF 4 2区 医学 Q2 ONCOLOGY
Translational lung cancer research Pub Date : 2024-08-31 Epub Date: 2024-08-28 DOI:10.21037/tlcr-24-604
Xuchang Li, Yangchen Xia, Chengyan Wang, Shanshan Huang, Qian Chu
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引用次数: 0

Abstract

Background: A previous network meta-analysis (NMA) compared the efficacy of anaplastic lymphoma kinase (ALK) inhibitors in ALK-positive non-small cell lung cancer (NSCLC). The phase III INSPIRE study of iruplinalkib was published recently. The present study aimed to add the results related to iruplinalkib to the NMA.

Methods: A systematic literature search was performed in PubMed, Embase, Cochrane Library, Google, and Baidu. Randomized controlled trials (RCTs) reporting the independent review committee-assessed progression-free survival (PFS), objective response rate (ORR), or disease control rate (DCR) results of Asian patients with ALK inhibitor-naïve advanced ALK-positive NSCLC were eligible for inclusion in the NMA. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Bayesian fixed-effect models were used for the direct and indirect pairwise comparisons. This study was registered with PROSPERO (CRD42024555299).

Results: Eight studies, involving 1,477 Asian patients and seven treatments (crizotinib, alectinib, brigatinib, ensartinib, envonalkib, iruplinalkib, and lorlatinib), were included in the NMA. In terms of the overall risks of bias, all of the studies had "some concerns". All the next-generation ALK inhibitors were statistically superior to crizotinib in terms of PFS. Iruplinalkib had the best surface under the cumulative ranking curve (74.0%), followed by brigatinib (69.1%) and ensartinib (63.7%). Most of the pairwise comparisons did not reveal significant differences in the ORR and DCR. In terms of both the ORR and DCR, alectinib ranked first, followed by lorlatinib.

Conclusions: Next-generation ALK inhibitors had better efficacy than crizotinib in the treatment of Asian patients with ALK inhibitor-naïve advanced ALK-positive NSCLC. Iruplinalkib may have more favorable PFS benefit than other ALK inhibitors for Asians.

ALK抑制剂对ALK抑制剂无效的亚洲晚期ALK阳性非小细胞肺癌患者的疗效:系统综述和网络荟萃分析。
背景:之前的一项网络荟萃分析(NMA)比较了无性淋巴瘤激酶(ALK)抑制剂对ALK阳性非小细胞肺癌(NSCLC)的疗效。最近发表了伊罗匹纳克(iruplinalkib)的III期INSPIRE研究。本研究旨在将依鲁帕林替尼的相关结果添加到NMA中:方法:在PubMed、Embase、Cochrane Library、Google和百度中进行了系统的文献检索。报告经独立审查委员会评估的亚洲 ALK 抑制剂无效的晚期 ALK 阳性 NSCLC 患者的无进展生存期(PFS)、客观反应率(ORR)或疾病控制率(DCR)结果的随机对照试验(RCT)符合纳入 NMA 的条件。偏倚风险采用 Cochrane Risk of Bias 2 工具进行评估。贝叶斯固定效应模型用于直接和间接配对比较。本研究已在 PROSPERO 注册(CRD42024555299):NMA纳入了8项研究,涉及1477名亚洲患者和7种治疗方法(克唑替尼、阿来替尼、布加替尼、安沙替尼、恩沃纳昔布、伊鲁普林昔布和洛拉替尼)。就总体偏倚风险而言,所有研究都存在 "一些问题"。在PFS方面,所有新一代ALK抑制剂在统计学上都优于克唑替尼。伊瑞帕替尼的累积排名曲线下表面最佳(74.0%),其次是布加替尼(69.1%)和安沙替尼(63.7%)。大多数配对比较并未显示出 ORR 和 DCR 的显著差异。就ORR和DCR而言,阿来替尼排名第一,其次是洛拉替尼:结论:在治疗ALK抑制剂无效的晚期ALK阳性NSCLC亚洲患者方面,新一代ALK抑制剂的疗效优于克唑替尼。与其他ALK抑制剂相比,Iruplinalkib可能对亚洲人的PFS更有利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
2.50%
发文量
137
期刊介绍: Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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