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Molecular Target Therapy · Journal article
Lung Cancer Management · July 27, 2026
Early or partial results. Treat as a signal, not a conclusion.
This retrospective single-centre study of 11 ALK-positive NSCLC patients receiving sequential ALK-TKIs reports median progression-free survival times decreasing with each treatment line (23, 17, 14, and 5 months) and median overall survival of 58 months from first ALK-TKI initiation. Brigatinib showed higher discontinuation rates due to adverse events (5 of 6 total discontinuations), but the very small sample size and lack of a comparator limit the strength of evidence.
Retrospective single-centre cohort study. Patients with ALK-positive NSCLC treated with sequential ALK-TKI therapies at a single centre; median age 59 years; 45.5% female.. Intervention: Sequential ALK-TKI therapy (Alectinib, Lorlatinib, Brigatinib, Ceritinib, Crizotinib); six patients also received cytotoxic chemotherapy.. n = 11. Single centre (not specified).
Median PFS was 23 months for first-line ALK-TKI, 17 months for second-line, 14 months for third-line, and 5 months for fourth-line treatment. Median OS from initiation of first ALK-TKI was 58 months. Six patients (54.5%) received cytotoxic chemotherapy in addition to ALK-TKIs.
Discontinuation due to adverse events occurred in 6 total treatment cases, with 5 (83.3%) attributed to Brigatinib.
This small case series provides descriptive evidence that sequential ALK-TKI therapy can achieve reasonable progression-free and overall survival in ALK-positive NSCLC, but clinicians should note the high frequency of Brigatinib-related discontinuations due to tolerability. The limited sample size precludes firm conclusions about treatment sequencing or relative efficacy across agents.
Small retrospective single-centre case series (n=11) describing treatment sequences and outcomes in ALK-positive NSCLC, with descriptive efficacy and safety data but no comparator group and high risk of selection bias.
As stated by the source record.
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This small case series provides descriptive evidence that sequential ALK-TKI therapy can achieve reasonable progression-free and overall survival in ALK-positive NSCLC, but clinicians should note the high frequency of Brigatinib-related discontinuations due to tolerability. The limited sample size precludes firm conclusions about treatment sequencing or relative efficacy across agents.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Introduction. Although sequential treatment with ALK-TKIs for ALK-positive lung cancer is commonly practiced in clinical settings, there are few reports on the actual treatment choices, efficacy and safety.Methods. This retrospective study evaluated the treatment sequence, progression-free survival (PFS), overall survival (OS), and adverse events (AEs) for the patients who received two or more ALK-TKIs.Results. Eleven patients were included in the study. The median age was 59 years, and five patients (45.5%) were female. The number of ALK-TKIs administered was two in five patients, three in five patients, and four in one patient. The drugs used were Alectinib in 10 patients, Lorlatinib in eight, Brigatinib in six, Ceritinib in three, and Crizotinib in two. Six patients (54.5%) had a history of treatment with cytotoxic chemotherapy in addition to ALK-TKIs. The most common first-line drug was Alectinib, followed by Brigatinib and Crizotinib. The median PFS for each treatment line was 23 months for the first line, 17 months for the second, 14 months for the third, and 5 months for the fourth. The median OS from 1st ALK-TKI was 58 months. Discontinuation of ALK-TKI due to adverse events occurred in six of the total treatment cases, and five of these (83.3%) were attributed to Brigatinib.Conclusion. Sequential treatment with different types of ALK-TKIs demonstrated a certain degree of efficacy. However, the incidence of discontinuation due to adverse events was higher for Brigatinib than for other ALK-TKIs.
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