國家衛生研究院 NHRI:Item 3990099045/15001
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/15001


    Title: Association of smoking and ALK tyrosine-kinase inhibitors on overall survival in treatment-naive ALK-positive advanced lung adenocarcinoma
    Authors: Zheng, ZR;Ku, HY;Chen, KC;Chiang, CJ;Wang, CL;Chen, CY;Tsai, CM;Huang, MS;Yu, CJ;Chen, JS;Chou, TY;Lee, WC;Wang, CC;Liu, TW;Hsia, JY;Chang, GC
    Contributors: National Institute of Cancer Research
    Abstract: IntroductionAnaplastic lymphoma kinase (ALK) fusion mutation is more common in younger and never-smoking lung cancer patients. The association of smoking and ALK-tyrosine kinase inhibitors (TKIs) on overall survival (OS) of treatment-naive ALK-positive advanced lung adenocarcinoma remains unclear in real-world. MethodsThis retrospective study evaluated all 33170 lung adenocarcinoma patients registered in the National Taiwan Cancer Registry from 2017 to 2019, of whom 9575 advanced stage patients had ALK mutation data. ResultsAmong the 9575 patients, 650 (6.8%) patients had ALK mutation with the median follow-up survival time 30.97 months (median age, 62 years; 125 [19.2%] were aged >= 75 years; 357 (54.9%) females; 179 (27.5) smokers, 461 (70.9%) never-smokers, 10 (1.5%) with unknown smoking status; and 544 (83.7%) with first-line ALK-TKI treatment). Overall, of 535 patients with known smoking status who received first-line ALK-TKI treatment, never-smokers and smokers had a median OS of 40.7 months (95% confidence interval (CI), 33.1-47.2 months) and 23.5 months (95% CI, 11.5-35.5 months) (P=0.015), respectively. Among never-smokers, those who received first-line ALK-TKI treatment had a median OS of 40.7 months (95% CI, 22.7-57.8 months), while those ALK-TKI not as first-line treatment had a median OS of 31.7 months (95% CI, 15.2-42.8 months) (P=0.23). In smokers, the median OS for these patients was 23.5 months (95% CI, 11.5-35.5 months) and 15.6 months (95% CI, 10.2-21.1 months) (P=0.026), respectively. Conclusions and relevanceFor patients with treatment-naive advanced lung adenocarcinoma, the ALK test should be performed irrespective of smoking status and age. Smokers had shorter median OS than never-smokers among treatment-naive-ALK-positive patients with first-line ALK-TKI treatment. Furthermore, smokers not receiving first-line ALK-TKI treatment had inferior OS. Further investigations for the first-line treatment of ALK-positive smoking advanced lung adenocarcinoma patients are needed.
    Date: 2023-03-17
    Relation: Frontiers in Oncology. 2023 Mar 17;13:Article number 1063695.
    Link to: http://dx.doi.org/10.3389/fonc.2023.1063695
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2234-943X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000961272000001
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85152579045
    Appears in Collections:[Tsang-Wu Liu] Periodical Articles

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