*For medical professionals for reading reference
How does NSCLC patients undergo ALK gene test?
Differential ALK (ALK) gene fusion is an important clinical subtype of non-small cell lung cancer (NSCLC) [1], International, multi-center, open label, and phase III clinical research CROWN studies confirmed that ALK-TKI treatment with Alki TKI represented by Lolatinib showed clinical benefits from the advanced NSCLC patients with Alk gene fusion: compared to Kizidinib (9.1 months), Lolatinib (NR) improved patients no progressive survival (PFS), and the risk of disease progress or death risk decreased by 81%(HR = 0.19).%Of the 5 -year PFS rate is higher than the 8%of the clipininib group, bringing a new preferred plan for the first -line therapy of Alks positive NSCLC [2].
Patients with lung cancer receiving genetic testing is a prerequisite for receiving ALK-TKI treatment, "China ALK Testing Clinical Practice Expert Consensus" clearly states that allPatients with pathological diagnosis of pulmonary adenocarcinoma (including adenocarcinoma) patients need ALK testing.Recommended ALK testing for advanced NSCLC patients diagnosed by biopsy for non-adenocarcinoma after the pathology of biopsy; then ALK-TKI treatment is received [1].
Select accurate, fast, and appropriate ALK detection methods to screen out the target group of Alk-TKI is important clinical significance.A large number of comparison studies have confirmed that there is a high compliance rate between the testing platforms, but there are still many problems in the test practice.Path recommendation, etc.In theory, for different detection people and test specimens, choose the appropriate detection method, and formulate, optimize and comply with the standardized testing process to obtain accurate test results, so that patients can be benefited to the greatest extent;The detection of the ALK gene still needs to be further clarified.
A clinical study was announced at the 2024 American Clinical Oncology Society (ASCO) Conference in 2024, which explored the situation of Alk gene test in the real world, which brought valuable clinical clinicals.Reference [3].This Weite interprets the results of the study to readers.
Early NSCLC ALK detection mode: a real world evidence research [3]
■ Research background
Patients with advanced NSCLC should conduct comprehensive biomarkers, but the current NSCLC biomarker testing practice is inconsistent.As the new clinical data and treatment schemes of patients with early diseases (ENSCLC) are constantly emerging, the known detection pulmonary drive mutations (LDM) and the corresponding detection environment are changing.
This study evaluates the current ALK detection rate of patients with phase IIIA ENSCLC, and determines the relevant factors for the timely receiving ALK detection of ENSCLC patients.
■ Research method
This research retrospective analysis of 2018 toIn 2023, patients diagnosed with Revisive L-LLA-stage NSCLC patients lacked ALK test results before the initial diagnosis, and used the expansion of the national (US) to identify the Flatronicon Health Electronic Health Records (EHR) database.Flatronicon Health database is a vertical database, including de-identified patient-grade structured and non-complicated data integrated from about 280 US cancer clinics (= 800 nursing points).With machine learning and artificial abstraction to extract patient characteristics.
In order to ensure that only patients who only analyze the status of early biomarkers, the researchers limited the sample to patients who performed ALK detection in ≥90 days before the late diagnosis date (if no advanced diagnosis occurred, no advanced diagnosis occurred, Any time).The indexing date is defined as the first diagnosis date; the patient follows the index date to 90 days before the ANSCLC diagnosis date, or the death (if there is no ANSCLC date, the follow -up fails).
The main ending is to perform ALK detection within 90 days after the initial diagnosis (in any way).This study also discussed whether the patient received ALK test after the initial diagnosis (but at least 90 days before ANSCLC diagnosis).The differences between Kruskal-Wallis rank and inspection and Pearson ’s X2 test analysis.The relationship between the characteristics of the patients characteristics and the possibility of ALK detection within 90 days after the first diagnosis of patients with a multi -variable logistic regression.The use of chain multiple attribution methods to attribute gender, race, geographical region, socioeconomic status (SES) index, SES), and the lack of practical types and smoking status.
■ Research results
A total of 24,076 cases of removal I-IIIA stageNSCLC patients meet all the group standards of this study (Figure 1).
Figure 1. Patient screening
7396 cases (31%) Testing within 90 days after the first diagnosis, 16680 cases (69%) were not tested (Table 1).3359 (14%) patients were tested before lung cancer surgery, and 2253 (9%) patients were tested after 90 days after diagnosis.
Table 1. Patients baseline features
Accept an ALK detection for multiple variable analysis within 90 days.If the patient confirms the diagnosis in recent years (2021-2023 VS 2018), the history of no smoking, the high SES (index 4-5), the treatment in the community environment, the medical subsidy (VS commercial) insurance or the disease in the later stage(II-IIIA period), then patients are more likely (all P
