OBJECTIVES:

Studies have shown that NSCLC patients with an anaplastic lymphoma kinase (ALK) rearrangement significantly benefit from ALK targeted therapy over standard chemotherapy. The objective of this study was to profile patients with an ALK positive mutation in both the US and Europe.

METHODS:

A multi-country retrospective medical chart review of patients with NSCLC patients in the US (n=4,058) and 5 European (EU5) countries (France, Germany, Italy, Spain, UK; n=13,689) was conducted between 7/2016 and 6/2017. Physicians randomly selected patient charts currently on an anti-cancer regimen and extracted data on patient demographics, disease status, treatment patterns, and biomarker status. Comparisons were made using chi-square and t-tests.

RESULTS:

ALK testing rates were higher in the EU5 (77%) than the US (70%; p<0.0001). Of those that were tested, 8% of patients in both the US (n=334) and EU5 (n=1,150) cohorts had an ALK mutation. There were no differences in mean age. A higher proportion of patients were functional in the US, as shown by an ECOG score of 0/1 (92% vs 78%; p<0.0001). Monotherapies prevailed across the lines of therapy and regions. In the US, 95% of first line treatments were ALK inhibitors, compared to 65% in the EU5, where ALK inhibitors were not as common (p<0.0001). The top 3 first line regimens were Crizotinib (85%), Alectinib (7%), and Ceritinib (3%) in the US, and Crizotinib (58%), Cisplatin/Pemetrexed (8%), and Cisplatin monotherapy (6%) in the EU5 cohort. Similarly, ALK inhibitors were more prevalent as second and third line therapies in the US compared to the EU5 cohort (p<0.05).

CONCLUSIONS:

ALK rearrangements were observed in <10% of the NSCLC population in both the US and EU5 cohorts. Crizotinib monotherapies dominated the market of ALK+ in both the US and EU5, with a higher proportion of ALK inhibitors observed in the US.