Mutlu HİZAL, Burak BİLGİN, Mehmet ŞENDUR, Şebnem YÜCEL, Seda KAHRAMAN, Cihan EROL, Muhammed Bülent AKINCI, Didem ŞENER DEDE, Efnan ALGIN, Bülent YALÇIN

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Birinci basamak alektinib tedavisi alan ALK mutasyonu pozitif akciğer kanseri hastalarının klinik özelliklerinin değerlendirilmesi

Giriş: Akciğer kanseri tüm dünyada cinsiyet ayırt etmeksizin en sık görülen ve en sık mortaliteye neden olan kanser tipidir. Tüm küçük hücre dışı akciğer kanseri (KHDAK) hastalarının %3-7’sinde anaplastik lenfoma kinaz (ALK) mutasyonu pozitif olarak saptanır. Bu iki merkezli çalışma ile ALK mutasyonu olan ve birinci basamak alektinib tedavisi alan KHDAK hastaların patolojik, klinik, demografik özelliklerinin araştırılması amaçlanmıştır. Materyal ve Metod: Ankara Şehir Hastanesi Tıbbi Onkoloji ve Atatürk Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji bölümlerinde takipli olan, KHDAK tanısı almış ve ALK mutasyonu pozitif gelen, tirozin kinaz inhibitörü olarak birinci basamakta Alektinib tedavisi alan hastalar retrospektif olarak incelendi. Bulgular: Çalışmaya toplam 38 hasta (15 erkek, 23 kadın) dahil edildi. Ortanca yaş 56,5 olarak bulundu. Hastaların %55,3’ünün hiç sigara içmediği, tümünün adenokanser alt tipinde olduğu saptandı. Otuz dört hasta (%89,5) metastatikti. Beyin metastazı %44,7 oranında saptandı. Otuz üç hastanın (%86,8) birinci basamakta alektinib kullandığı görüldü. Geri kalan beş hastanın daha önce en az bir kür kemoterapi tedavisi aldığı görüldü. Alektinib tedavisiyle objektif yanıt oranı %78,9 gözlendi. En az bir tane yan etki bildirilen hasta oranının %34,2; ciddi yan etki görülen hasta oranının %7,9 olduğu saptandı. Ortanca 9,5 ay takipten sonra, ortanca progresyonsuz sağkalıma (PS) ulaşılamadı. 24-aylık PS %67, 24 aylık genel sağkalım %84 olarak bulundu. Sonuç: Çalışmamıza alınan hasaların sonuçları incelendiğinde klinik, patolojik ve demografik verilerinin geçmiş çalışmalarla uyumlu olduğu görülebilir. Sigara içmeyen, göreceli olarak genç, kadın hastaların çoğunlukta olduğu görülmüştür. Alektinib tedavisiyle literatürle benzer yanıt oranı ve sağkalım sonuçları alınabileceği görülmüştür.

Clinical features of the ALK-mutant non-small cell lung cancer patients who received first-line alectinib treatment

Introduction: Lung cancer is the most common cancer type and the leading cause of cancer-related mortality worldwide. The positivity rate of the anaplastic lymphoma kinase (ALK) mutation in non-small cell lung cancer (NSCLC) patients has been reported as 3-7%. This study aimed to investigate the pathological, clinical and demographic characteristics of ALK-mutant NSCLC patients who received first-line alectinib as a tyrosine kinase inhibitor in two different centers. Materials and Methods: The study was performed at the Medical Oncology Departments of Ankara City Hospital and Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital. Patients diagnosed with ALK-mutant NSCLC and received alectinib treatment as a first-line tyrosine kinase inhibitor were enrolled to study and retrospectively analyzed. Results: A total of 38 patients (15 males, 23 females) were included in the study. Median age was 56.5. 55.3% of the patients were non-smokers. All of the patients had adenocarcinoma histology. Thirty-four patients (89.5%) were metastatic. Brain metastasis was detected in 44.7% of the patients. Thirty-three patients (86.8%) were using alectinib in first-line treatment. The remaining five patients were seen to have received at least one course of chemotherapy before. The objective response rate was 78.9% with alectinib treatment. The percentage of the patients who experienced at least one side effect was 34.2% and serious side effects were 7.9%. After median 9.5 months follow-up, median progression-free survival (PFS) was not achieved. 24-month PFS was 67% and 24-month overall survival was 84%. Conclusion: Our results were compatible with previous studies in terms of the clinical, pathological and demographic features of the patients with ALK mutation. We observed that the majority of patients were non-smokers, relatively young, and female patients. The objective response rate and survival results were similar with phase 3 studies.
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Tüberküloz ve Toraks-Cover
  • ISSN: 0494-1373
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1951
  • Yayıncı: Tuba Yıldırım
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