Real-World Patient Characteristics, Treatment Patterns, and Survival among Locally-Advanced/Metastatic Alk+ Non-Small Cell Lung Cancer Patients in Latin America

Abstract

Objectives To describe patient characteristics, treatment patterns, and survival among Latin American patients diagnosed with locally-advanced/metastatic ALK+ non-small cell lung cancer (NSCLC). Methods Mexican and Argentine oncologists (N=5) reviewed patient charts and reported characteristics, treatment patterns, and survival on their patients diagnosed with ALK+ locally-advanced/metastatic NSCLC. Treatment duration and overall survival (OS) were estimated using Kaplan-Meier analyses. Results Patients (N=25) averaged 57 years old when diagnosed with locally-advanced/metastatic NSCLC; 64% were female, 56% were Hispanic, 44% were Caucasian, 48% were uninsured, and 24% were unemployed or on sick leave. Smoking history varied (36% never-smokers, 20% light/moderate smokers, and 32% heavy smokers). At primary diagnosis, 72% had metastatic disease. Over the course of their disease (until end of follow-up), 48% of patients developed brain metastases, 20% bone, and 32% lung. In first-line therapy, 17 patients (68%) received chemotherapy and six patients (24%) received crizotinib. After first-line chemotherapy, six patients (24%) received crizotinib. 13 patients (52%) never received an ALK inhibitor; of these, nine patients (69%) did not receive crizotinib because they could not afford it or crizotinib was not covered by insurance. Out of the 12 patients who received crizotinib, three died, and eight discontinued by the end of follow-up (median duration of 127 days), with three patients switching to chemotherapy, one to afatinib, and four receiving no further antineoplastic therapy. After diagnosis of locally-advanced/metastatic NSCLC, the OS rate among all patients was 74% at 12 months. Conclusions Though the sample size is small, the study provides the first analysis of patient characteristics, treatment patterns, and survival among ALK+ NSCLC patients in Latin America. Many patients were women, uninsured, never received an ALK inhibitor, and their OS was low. These findings suggest that there could be an unmet need for access to effective treatments for ALK+ NSCLC patients in Latin America.