ASCO 2014 - Abstract 8002

ASCO 2014. Abstract 8002. First-line crizotinib versus pemetrexed–cisplatin or pemetrexed–carboplatin in patients (pts) with advanced ALK-positive non-squamous non-small cell lung cancer (NSCLC): results of a phase III study (PROFILE 1014)

Tony Mok, Dong-Wan Kim, Yi-Long Wu, Benjamin J. Solomon, Kazuhiko Nakagawa, Tarek Mekhail, Enriqueta Felip, Federico Cappuzzo, Jolanda Paolini, Tiziana Usari, Jennifer Tursi, Fiona Helen Blackhall; The Chinese University of Hong Kong, Hong Kong, China; Seoul National University Hospital, Seoul, South Korea; Guangdong Lung Cancer Institute, Guangdong General Hospital (GGH) and Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Medical Oncology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan; Florida Hospital, Orlando, FL; Vall d'Hebron University Hospital, Barcelona, Spain; Istituto Toscano Tumori, Department of Medical Oncology, Civil Hospital of Livorno, Livorno, Italy; Pfizer Oncology, Milano, Italy; The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom

Study Design:

Figure 1

Figure 1

Figure 2

Figure 2

The ALK fusion as a driver mutation in NSCLC is well known. The immediate approval of crizotinib by both the FDA and Health Canada following the high response rate in patients with an ALK mutation was understood and accepted. NCCN guidelines quickly followed to recommend crizotinib in the first line setting. Canada was more conservative asking for survival efficacy.

Last year’s ESMO meeting 2013, the second line trial showed crizotinib to have survival advantage over chemotherapy in this setting. The pan Canadian Drug Review Panel recommendation followed restricting crizotinib to the second line setting.

At this year’s ASCO the first line trial was presented. Patients with an ALK mutation randomized to crizontinb had a progression free survival of 10.9 months vs pemetrexed/cisplatin doublet of 7.0 months (p< 0.0001) (see Figure 2). This was not a surprise. This was an ASCO poster highlight as US practice was adopted long ago.

We look forward this abstract changing the Canadian practice.
— CARE Lung Cancer Faculty