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Real-World Use and Outcomes of ALK-Positive Crizotinib-Treated Metastatic NSCLC in US Community Oncology Practices: A Retrospective Observational Study

Florida Cancer Specialists and Research Institute, Ocala, FL 34471, USA
The US Oncology Network/McKesson Specialty Health, The Woodlands, TX 77380, USA
Pfizer Oncology, New York, NY 10017, USA
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(6), 129;
Received: 8 May 2018 / Accepted: 15 May 2018 / Published: 29 May 2018
PDF [571 KB, uploaded 29 May 2018]


Introduction: Around 3–5% of non-small cell lung cancers (NSCLC) are ALK-positive. Crizotinib was the first approved ALK inhibitor from clinical trials. However, there are less data on the utilization and patient outcomes associated with crizotinib in real-world clinical practice. Methods: This was a retrospective, observational study of adult crizotinib-treated ALK-positive metastatic NSCLC patients who received treatment between 1 September 2011 and 31 October 2014, with follow up through 31 December 2015. Data were obtained via programmatic queries of the US Oncology Network/McKesson Specialty Health electronic health record database, supplemented with chart abstraction. Overall survival (OS) and time to treatment failure (TTF) were estimated from crizotinib initiation using the Kaplan–Meier (KM) method. Results: Of the n = 199 ALK-positive crizotinib-treated patients meeting eligibility criteria, crizotinib was prescribed as first line (1 L) in n = 123 (61.8%). The majority (88.9%) had confirmed adenocarcinoma histology and 32.2% had brain metastases at initial diagnosis. Median age at crizotinib initiation was 60.2 years (range 27.1–88.2); 54.8% were never smokers, 33.7% were former smokers. Treatment of 250 mg, twice daily, was most commonly prescribed (89.5%) with the dose unchanged from an initial dose in 79.4% of patients. The primary discontinuation reason was progression (n = 91, 58.7%). Patients (3.2%) were identified as discontinuing crizotinib as a result of treatment-related toxicity. With median follow-up time of 13.0 months (min–max = 0.03–46.6), median OS from crizotinib initiation was 33.8 months (95% CI = 24.3–38.8). Median TTF was 10.4 months. Conclusions: Crizotinib usage evaluated within the real-world setting is consistent with prior phase III clinical trial data, and illustrates the real-world effectiveness of crizotinib. View Full-Text
Keywords: crizotinib; real-world utilization; patient outcomes; advanced NSCLC; ALK-positive crizotinib; real-world utilization; patient outcomes; advanced NSCLC; ALK-positive

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Reynolds, C.; Masters, E.T.; Black-Shinn, J.; Boyd, M.; Mardekian, J.; Espirito, J.L.; Chioda, M. Real-World Use and Outcomes of ALK-Positive Crizotinib-Treated Metastatic NSCLC in US Community Oncology Practices: A Retrospective Observational Study. J. Clin. Med. 2018, 7, 129.

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