ALK Positive Lung Cancer: Clinical Profile, Practice and Outcomes in a Developing Country

<div><p>Objectives</p><p>To evaluate the performance and treatment profile of advanced EML4—ALK positive Non-small cell lung cancer (NSCLC) patients in a developing country with potentially restricted access to Crizotinib.</p><p>Materials and Methods</p><p>A retrospective analysis of advanced ALK positive NSCLC patients who were treated from June 2012 to September 2015 was conducted. The primary goal was to evaluate outcomes of advanced ALK positive NSCLC in our practice and examine the logistic constraints in procuring Crizotinib.</p><p>Results</p><p>94 patients were available for analysis. 21 (22.3%) patients were started on Crizotinib upfront, 60 (63.8%) on chemotherapy, 10 (10.6%) on Tyrosine kinase inhibitors (in view of poor PS) and 3 (3.2%) patients were offered best supportive care. Reasons for not starting Crizotinib upfront included symptomatic patients needing early initiation of therapy (23.3%), ALK not tested upfront (23.3%) and financial constraints (21.9%). 69 patients (73.4%) received Crizotinib at some stage during treatment. Dose interruptions (> 1 week) with Crizotinib were seen in 20 patients (29%), with drug toxicity being the commonest reason (85%). Median Progression free survival (PFS) on first line therapy for the entire cohort was 10 months, with a significant difference between patients receiving Crizotinib and those who did not ever receive Crizotinib (10 months vs. 2 months, p = 0.028). Median Overall Survival (OS) was not reached for the entire cohort, with 1 year survival being 81.2%. Patients with an ECOG Performance Status (PS) of >2 had a significantly reduced PFS compared to patients with PS < = 2 (1.5 months vs. 11 months, p< 0.001). 47 patients with financial constraints (68.1%) received Crizotinib completely free via various extramural support schemes.</p><p>Conclusion</p><p>A majority of our ALK positive NSCLC patients were exposed to Crizotinib through the help of various support mechanisms and these patients had similar outcomes to that reported from previously published literature.</p></div

sj-docx-1-cll-10.1177_09636897241226573 – Supplemental material for Withania Somnifera Extract Mitigates Experimental Acute Graft versus Host Disease Without Abrogating Graft Versus Leukemia Effect

Supplemental material, sj-docx-1-cll-10.1177_09636897241226573 for Withania Somnifera Extract Mitigates Experimental Acute Graft versus Host Disease Without Abrogating Graft Versus Leukemia Effect by Saurabh Kumar Gupta, Dievya Gohil, Mohd Bashar Momin, Subhash Yadav, Akanksha Chichra, Sachin Punatar, Anant Gokarn, Sumeet Mirgh, Nishant Jindal, Lingaraj Nayak, Lal Hingorani, Navin Khattry and Vikram Gota in Cell Transplantation</p

Overall Survival as per Performance Status.

<p>Overall Survival as per Performance Status.</p

Progression Free Survival as per exposure to Crizotinib.

<p>Progression Free Survival as per exposure to Crizotinib.</p

Study Outline.

<p>Study Outline.</p

Progression Free Survival as per Performance Status.

<p>Progression Free Survival as per Performance Status.</p

Adverse Events and safety.

<p>Adverse Events and safety.</p

Overall Survival as per exposure to Crizotinib.

<p>Overall Survival as per exposure to Crizotinib.</p

Demographic Data and baseline tumor characteristics.

<p>Demographic Data and baseline tumor characteristics.</p

Response rates, Survival and pattern of progression on Crizotinib.

<p>Response rates, Survival and pattern of progression on Crizotinib.</p