ALK+ Overall Survival prospects

Portal Forums Lung/Thoracic Cancer ALK Inhibitors ALK+ Overall Survival prospects

This topic contains 2 replies, has 2 voices, and was last updated by  beeg2017 2 months, 2 weeks ago.

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December 29, 2017 at 10:17 am  #1293683    


I was diagnosed with stage IV adenocarcinoma in Sept 2017. I’ve successfully had radiation for lung tumor and spine tumor reduction. I’ve completed two cycles of chemo (carbo/peme/avastin) before learning I was ALK+. The chemo + radiation reduced my lung tumor by ~65% and the lymph nodes and spine tumors are stabilized. I’m now on Alectinib since mid Dec 2017. I’ve been doing a lot of research on my survival prospects on ALK+ mutation but most of the data is old (some Canadian study had data that was dated). Given the advancement of the new TKIs I’m looking for something more recent. I know most people go through 3+ TKIs before they’ve exhausted targeted treatment and then jump to chemo or I’ve even heard of some trying immunotherapy in the final stages. With the lack of recent overall survival data should I just add the median PFS numbers for 3 TKIs (e.g. 25.7 mos for Alectinib + 12.9 mos for brigatinib + 7.7 for Crizotinib) and then make an assumption for chemo after the TKIs wear off? I know people don’t like to talk about this because it involves your own mortality but it gives me a baseline to try and beat.

December 30, 2017 at 8:33 am  #1293685    
JimC Forum Moderator
JimC Forum Moderator

Hi beeg2017,

Welcome to GRACE. Congratulations on your good response to treatment. Many of us who have dealt with a lung cancer diagnosis, whether as patients or caregivers, have a similar desire to find the answer to the question you pose – what can I expect in terms of survival, whether it’s overall survival or progression free survival? Unfortunately, there isn’t a good answer. Adding the PFS statistics for each of the 3 TKIs is one way to look at it, but adding a median on top of a median on top of yet another median doesn’t apply very well to an individual patient. The medians for each agent also vary based on whether they are used in first line or later therapy, and whether a patient has received prior, non-TKI treatment, as you have. In addition, patients who better a median on one therapy tend to do better on another.

Still, there’s probably not a better way to set a goal, and I hope that you continue to show good results for a long time to come.

Forum moderator

Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then:

December 31, 2017 at 8:10 am  #1293686    


Thanks for your reply. I was able to find some more recent data:

Turns out the median Overall Survival is 49 months from the first brain met from the one study. The second study says the median was not met after 48months. My estimate by adding the PFS of 3 TKIs plus an allowance for post TKI treatment was somewhere in the mid 50 mos so it calibrates. I’m hoping the new drugs in the pipeline (lorlatinib, ensartinib) will show promising data for second and third line treatments to extend the prospects even further.

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