Efficacy of Crizotinib, Ceritinib, and Alectinib in ALK-Positive Non-Small Cell Lung Cancer Treatment: A Meta-Analysis of Clinical Trials
Open Access
- 25 February 2020
- Vol. 12 (3), 526
- https://doi.org/10.3390/cancers12030526
Abstract
This study aimed to evaluate the efficacy of anaplastic lymphoma kinase (ALK)-inhibitors in the treatment of ALK-positive non-small cell lung cancer (NSCLC) by using a meta-analysis of clinical trials. We searched PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov by using keywords related to the topic in August 2018. The pooled effect sizes were calculated based on a random-effects model. We also performed subgroup meta-analysis by types of ALK inhibitors (crizotinib, ceritinib, and alectinib). A total of 20 clinical trials with 10 single-arm trials and 10 double-arm trials were included in the final meta-analysis. The median overall survival (OS), progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), 1 year survival rate, and 2 year survival rate were 19.14 months, 8.47 months, 62%, 78%, 74%, and 62%, respectively. ALK inhibitors showed a significantly superior efficacy compared with chemotherapy (hazard ratio (HR) for OS, 0.83; HR for PFS, 0.43; rate difference (RD) for ORR, 0.23; and RD for DCR, 0.10). The current meta-analysis of clinical trials showed the significant efficacy of ALK inhibitors in the treatment of ALK-positive NSCLC. Further head-to-head trials are needed to compare their efficacy with other types of NSCLC treatment regimens. PROSPERO registration: CRD42018085987.This publication has 37 references indexed in Scilit:
- Activity and safety of ceritinib in patients with ALK-rearranged non-small-cell lung cancer (ASCEND-1): updated results from the multicentre, open-label, phase 1 trialThe Lancet Oncology, 2016
- Alectinib in ALK-positive, crizotinib-resistant, non-small-cell lung cancer: a single-group, multicentre, phase 2 trialThe Lancet Oncology, 2015
- Efficacy and tolerability of crizotinib in the treatment of ALK-positive, advanced non-small cell lung cancer in Chinese patientsMedical Oncology, 2015
- Overall Response Rate, Progression-Free Survival, and Overall Survival With Targeted and Standard Therapies in Advanced Non–Small-Cell Lung Cancer: US Food and Drug Administration Trial-Level and Patient-Level AnalysesJournal of Clinical Oncology, 2015
- Role of PAX8 in the regulation of MET and RON receptor tyrosine kinases in non-small cell lung cancerBMC Cancer, 2014
- Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer: updated results from a phase 1 studyThe Lancet Oncology, 2012
- The emerging role of ALK inhibitors in the treatment of advanced non-small cell lung cancerEmerging Therapeutic Targets, 2012
- A basic introduction to fixed-effect and random-effects models for meta-analysisResearch Synthesis Methods, 2010
- Progression-Free SurvivalThe Cancer Journal, 2009
- A comparison of methods to detect publication bias in meta‐analysisStatistics in Medicine, 2001