Systematic review and meta-analysis of selected toxicities of approved ALK inhibitors in metastatic non-small cell lung cancer

Rubens Barros Costa*, Ricardo L.B. Costa, Sarah M. Talamantes, Jason B Kaplan, Manali A. Bhave, Alfred W Rademaker, Corinne Miller, Benedito A. Carneiro, Devalingam Mahalingam, Young Kwang Chae

*Corresponding author for this work

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Introduction: Anaplastic lymphoma kinase (ALK) inhibitors are the mainstay treatment for patients with non-small cell lung carcinoma (NSCLC) harboring a rearrangement of the ALK gene or the ROS1 oncogenes. With the recent publication of pivotal trials leading to the approval of these compounds in different indications, their toxicity profile warrants an update. Materials and Methods: A systematic literature search was performed in July 2017. Studies evaluating US FDA approved doses of one of the following ALK inhibitors: Crizotinib, Ceritinib, Alectinib or Brigatinib as monotherapy were included. Data were analyzed using random effects meta-analysis for absolute risks (AR), study heterogeneity, publication bias and differences among treatments. Results: Fifteen trials with a total of 2,005 patients with evaluable toxicity data were included in this report. There was significant heterogeneity amongst different studies. The pooled AR of death and severe adverse events were 0.5% and 34.5%, respectively. Grade 3/4 nausea, vomiting, diarrhea, and constipation were uncommon: 2.6%, 2.5%, 2.7%, 1.2%, respectively. Conclusions: ALK inhibitors have an acceptable safety profile with a low risk of treatment-related deaths. Important differences in toxicity profile were detected amongst the different drugs.

Original languageEnglish (US)
Pages (from-to)22137-22146
Number of pages10
JournalOncotarget
Volume9
Issue number31
StatePublished - Apr 24 2018

Keywords

  • Alectinib
  • Anaplastic lymphoma kinase
  • Brigatinib
  • Ceritinib
  • Crizotinib

ASJC Scopus subject areas

  • Oncology

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    Costa, R. B., Costa, R. L. B., Talamantes, S. M., Kaplan, J. B., Bhave, M. A., Rademaker, A. W., Miller, C., Carneiro, B. A., Mahalingam, D., & Chae, Y. K. (2018). Systematic review and meta-analysis of selected toxicities of approved ALK inhibitors in metastatic non-small cell lung cancer. Oncotarget, 9(31), 22137-22146.