@article{3312109f7b984e8e9e4a067143fb16ad,
title = "Crizotinib Versus Conventional Chemotherapy in First-Line Treatment for ALK-Positive Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis",
abstract = "Introduction: Lung cancer is the most frequently diagnosed type of cancer and the main cause of death from malignant neoplasms worldwide. One of the most recent discoveries in the context of non-small cell lung cancer (NSCLC) was the mutation of the anaplastic lymphoma kinase receptor (ALK). This genetic alteration is found in approximately 2–5% of NSCLC patients, and crizotinib was the first targeted therapy discovered for its first-line treatment. Objective: To conduct a systematic review and meta-analysis to estimate the magnitude of the overall survival (OS) and progression-free survival (PFS) from using crizotinib as treatment compared to traditional chemotherapy to guide future decision making. Methods: PRISMA and Cochrane recommendations were followed using the findings based on studies published in the main international electronic databases. Selection criteria included the following: randomized clinical trials (RCT) or cohort studies that had assessed the efficacy and effectiveness of crizotinib as monotherapy in patients with NSCLC with ALK fusions. Results: From 2504 publications identified in the literature, only eight publications referring to seven studies met the selection criteria, with high heterogeneity identified between the studies. Overall, there was a significant gain in PFS (HR 0.38; 95% CI 0.30–0.49; p < 0.00001); however, there was no significant gain in OS (HR 0.68; 95% CI 0.43–1.08; p = 0.10). Conclusion: The study highlighted and confirmed that treatment with crizotinib led to clinical improvement in PFS among patients with advanced NSCLC with ALK fusion, as previously reported. However, there was no increase in overall survival in patients with NSCLC with genetic alterations of ALK. This must be considered when reviewing and funding treatments for NSCLC patients with this mutation.",
keywords = "Anaplastic lymphoma kinase, Crizotinib, Effectiveness, Efficacy, Lung cancer, Systematic review",
author = "Cruz, {Barbara D.} and Barbosa, {Mariana M.} and Torres, {Lucas L.} and Azevedo, {Pamela S.} and Silva, {V{\^a}nia E.A.} and Brian Godman and Juliana Alvares-Teodoro",
note = "Funding Information: The authors would like to thank Professor Francisco de Assis Ac{\'u}rcio, Dr. Pedro Nazareth Aguiar Junior and Dr. Fl{\'a}via Marini for the support, adjustments and useful advice that improved this article. No funding or sponsorship was received for this study or publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. The first draft of the manuscript was written by Barbara Delano Cruz and all authors commented on previous versions, read and approved the final manuscript. BDC contributed with the original idea, conceptualization of the study, investigation, research, data curation, formal analysis, methodology, project management, software, validation, supervision, writing, review, and editing. Material preparation, data collection and analysis were performed by BDC, Mariana Michel Barbosa, Lucas Lima Torres, Pamela Santos Azevedo, V{\^a}nia Eloisa de Ara{\'u}jo e Juliana Alvares-Teodoro. MMB and Brian Godman contributed with data curation, methodology, formal analysis, supervision, writing-review, and editing. LLT contributed to research, software, and validation. PSA contributed to the investigation, software, methodology, and validation. VEAS contributed to the investigation, software, methodology, and validation. JAT contributed formal analysis, methodology, project management, validation, supervision, writing, reviewing, and editing. The authors (Barbara D Cruz; Mariana M Barbosa; Lucas L Torres; Pamela S Azevedo; V{\^a}nia E A Silva; Brian Godman, Juliana Alvares-Teodoro) have nothing to disclose. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Publisher Copyright: {\textcopyright} 2021, The Author(s).",
year = "2021",
month = dec,
doi = "10.1007/s40487-021-00155-3",
language = "English",
volume = "9",
pages = "505--524",
journal = "Oncology and Therapy",
issn = "2366-1070",
publisher = "Springer International Publishing AG",
number = "2",
}