METASTASES CEREBRALES DES CANCERS BRONCHIQUES ALK REARRANGÉS - LESS IS MORE FABRICE BARLESI, MD, PHD - ONCOHIGHLIGHTS 2020
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Metastases cerebrales des cancers
bronchiques alk rearrangés
Less is more
FABRICE BARLESI, MD, PhD
Institut Gustave Roussy - Paris
M-MA-00000097
Le contenu et l’interprétation de ces diapositives reflètent le point de vue
de l’orateur et non celui de Roche.
Les informations présentées pourraient comporter des données relatives à
des produits non enregistrés ou à des indications non approuvées au Maroc.
La cadre de cette présentation est scientifique et nullement promotionnel.
Disclosures
● Personal financial interests:
> Astra-Zeneca, Bayer, Bristol-Myers Squibb, Boehringer–Ingelheim, Eli Lilly Oncology, F. Hoffmann–La
Roche Ltd, Novartis, Merck, Mirati, MSD, Pierre Fabre, Pfizer, Seattle Genetics and Takeda
● Institutional financial interests:
> Abbvie, ACEA, Amgen, Astra-Zeneca, Bayer, Bristol-Myers Squibb, Boehringer–Ingelheim, Eisai, Eli Lilly
Oncology, F. Hoffmann–La Roche Ltd, Genentech, Ipsen, Ignyta, Innate Pharma, Loxo, Novartis,
Medimmune, Merck, MSD, Pierre Fabre, Pfizer, Sanofi-Aventis and Takeda
● Non-financial interests:
> Principal Investigator for Astra-Zeneca, BMS, Merck, Pierre Fabre and F. Hoffmann-La Roche, Ltd,
sponsored trials (or ISR)
● No other conflicts of interest
28/01/2021 Gustave Roussy Cancer Center 3
Brain metastases as an issue
• A frequent concern for ALK+ patients
• ~35% of patients with ALK+ NSCLC at initial diagnosis
• Frequently non eligible to radio/neuro surgical management
with CNS mets (%) 60
ALK+ NSCLC pts
40
20
0
1 2 3 ≥4
Number of brain metastases at first imaging
Gainor JF et al, Cancer Discov 2016
Brain metastases as an issue
• A frequent concern for ALK+ patients
• Also during the course
of the disease
Griesinger F, et al. Oncotarget. 2018; Patil T, et al. J Thorac Oncol. 2018; Drilon et al., J Thorac Oncol 2018
Efficacité des inhibiteurs de ALK dans les metastases cérébrales ? De la 1ère génération aux inhibiteurs les plus récents
Brain mets is no longer an issue?
• Proven superiority of new ALK TKIs over Crizotinib to treat BM
Peters S et al, NEJM 2017; Camidge R, et al. ESMO Asia 2019; Solomon B, et al. ESMO 2020Brain mets is no longer an issue?
• Proven superiority of new ALK TKIs over Crizotinib to prevent BM
50 41.4%
Cumulative incidence (%)
(95% CI: 33.2–49.4)
40
Crizotinib (n=151)
Alectinib (n=152)
30
20 9.4%
(95% CI: 5.4–14.7)
10
0
0 6 12 18 24 30
Time (months)
Crizotinib (n=151) Alectinib (n=152)
Patients with events, n (%) 68 (45) 18 (12)
Cause-specific HR 0.16
(95% CI: 0.10–0.28) pBrain mets is no longer an issue?
• Characteristics of patients
with brain mets included
in clinical trials
Aldea M, et al,
European Oncology & Haematology 2020Brain mets is no longer an issue?
• Intracranial ORR and Duration of Response
Aldea M, et al, European Oncology & Haematology 2020Toxicité cognitive de la radiothérapie dans les metastases cérébrales ? Peu de données mais …
Cognitive decline with brain radiotherapy
Increased by WBRT Cognitive tests show decrease in
• Episodic memory executive
PGuidelines Sed Lex
ESMO Guidelines
• Systemic treatment alone is the recommandation
In patients with CNS involvement, front-line use of ALK TKIs is effective,
and alectinib [III, A] or ceritinib [IV, B] is recommended, while interim
analysis of ALTA-1L brigatinib data establish this drug in this setting too
[III, A; EMA-approved].
Planchard D, et al. Ann Oncol 2018, Updated Sep 2020fabrice.barlesi@gustaveroussy.fr
@barlesiPour toute information médicale sur les produits Roche, veuillez nous contacter à l’adresse :
email: morocco.medinfo@roche.com, par téléphone : 05 22 95 90 00 ou par fax : 05 22 95 90 01
Pour toute notification d’évènements indésirables, veuillez nous contacter à l’adresse :
email: morocco.drug_safety@roche.com, par téléphone : 06 61 17 83 67/ 05 22 95 90 58
ou par fax : 05 22 95 90 59
Roche Maroc S.A. Ivoire 05, Casablanca Marina Bvd Sidi Mohamed Ben Abdellah Casablanca, MAROCYou can also read
