Beyond EML4: efficacy of targeted therapy in lung cancer patients with rare ALK fusions – a real-world retrospective analysis
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
- Department of Internal Medicine I
- Institute of Pathology
- National Center for Tumor Diseases Dresden
- University Hospital Carl Gustav Carus Dresden
- National Network Genomic Medicine Lung Cancer (nNGM)
- University of Cologne
- Ludwig Maximilian University of Munich
- Klinik Floridsdorf
- Karl Landsteiner Society
- Heidelberg University
- Translational Lung Research Center Heidelberg (TLRC) - DZL Heidelberg
- University of Regensburg
- Immenhausen Lung Clinic
- University Hospital Tübingen
- Robert Bosch Krankenhaus Stuttgart
- Dr. Margarete Fischer-Bosch-Institut für Klinische Pharmakologie
- University of Tübingen
- Justus Liebig University Giessen
- Friedrich-Alexander University Erlangen-Nürnberg
- Cantonal Hospital Baden
- Evangelical Lung Clinic Berlin
- Karl Landsteiner University of Health Sciences
- University Hospital Krems
- University of Ljubljana
- University Medical Center Freiburg
- University of Göttingen
- Heinrich Heine University Düsseldorf
- University Hospital Frankfurt
- Cantonal Hospital Winterthur
- Fresenius AG
- University Hospital Essen
- Klinikum Esslingen
- Ulm University
- University of Bern
- Samson Assuta Ashdod Medical Center
- Shaare Zedek Medical Center
- General Hospital Maribor
- National and Kapodistrian University of Athens
- University of Hamburg
Abstract
Evidence on prognosis and optimal treatment for patients with advanced NSCLC harboring non-EML4-ALK fusions (rare ALK) remains limited. In a retrospective real-world cohort from 29 centers across six countries, overall survival (OS) appeared shorter in patients with rare ALK fusions (n = 51) compared with those with EML4-ALK fusions (n = 277; median 27 vs. 57 months, p = 0.08). Among patients receiving first-line therapy, those with rare ALK fusions experienced significantly shorter progression-free survival (PFS) with platinum-based chemotherapy than with a TKI (5 vs. 23 months; HR 3.1, 95% CI 1.2-8, p = 0.02). In contrast, for patients treated first-line with an ALK-TKI, ORR (85% vs. 74%; p = 0.9) and PFS (median 25 vs. 23 months; HR 0.9, 95% CI 0.6-1.5) were similar between rare ALK and EML4-ALK groups. These findings support TKIs as preferred first-line therapy for advanced NSCLC with rare ALK fusions.
Details
| Original language | English |
|---|---|
| Article number | 248 |
| Journal | npj Precision Oncology |
| Volume | 10 |
| Issue number | 1 |
| Publication status | Published - 29 Jun 2026 |
| Peer-reviewed | Yes |
External IDs
| PubMedCentral | PMC13314944 |
|---|---|
| Scopus | 105043473231 |