Evidence map›Paper›PMID 37334877›Full record

ArticleCancer medicine2023

A Bayesian network meta-analysis of ALK inhibitor treatments in patients with ALK-positive non-small cell lung cancer.

Bei Zheng, Hong Jiang, Wenjuan Yang, Ying Li, Bingqing Liang, Jun Zhu, Nanmei Chen, Miao Chen, Meiling Zhang

Open access · goldAbstract readNetwork Meta-Analysis
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
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  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Bei ZhengDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.ORCID 0000-0003-0575-1607
Hong JiangDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.
Wenjuan YangDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.
Ying LiDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.
Bingqing LiangDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.
Jun ZhuDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.
Nanmei ChenDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.
Miao ChenDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.
Meiling ZhangDepartment of Pharmacy, Tongde Hospital Zhejiang Province, Hangzhou, China.ORCID 0000-0002-1023-8827
Tongde Hospital of Zhejiang Province · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo date, no direct comparisons have compared the effectiveness of all ALK inhibitors (ALKis) against ALK-positive non-small cell lung cancer (NSCLC). The aim of the present study was to investigate the efficacy and safety of ALKis in ALK-positive NSCLC.

methodsThe effectiveness of ALKis was evaluated by assessing progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and PFS with baseline brain metastasis (BM). The serious adverse events (SAEs: Grade ≥ 3) and adverse events (AEs) leading to discontinuation were pooled to evaluate safety. We conducted an indirect treatment comparison between all ALKis by using a Bayesian model.

resultsTwelve eligible trials including seven treatments were identified. All of the ALKis improved PFS and ORR relative to chemotherapy. Consistent with alectinib, brigatinib, lorlatinib, and ensartinib showed significant differences versus crizotinib and ceritinib. Lorlatinib seemed to prolong PFS compared with alectinib (0.64, 0.37 to 1.07), brigatinib (0.56, 0.3 to 1.05), and ensartinib (0.53, 0.28 to 1.02). No significant difference was found among them in OS except for alectinib versus crizotinib. Moreover, alectinib was significantly more effective than crizotinib (1.54, 1.02 to 2.5) in achieving the best ORR. Subgroup analyses based on BM indicated that PFS was dramatically lengthened by lorlatinib. Compared with other ALKis, alectinib notably reduced the rate of SAEs. There was no striking difference between discontinuation for AEs, except for ceritinib versus crizotinib. The ranking of validity showed that lorlatinib had the longest PFS (98.32%) and PFS with BM (85.84%) and the highest ORR (77.01%). The rank of probabilities showed that alectinib had the potentially best safety in terms of SAEs (97.85%), and ceritinib had less discontinuation (95.45%).

conclusionAlectinib was the first choice for patients with ALK-positive NSCLC and even for those with BM, whereas lorlatinib was the second choice. Long-term follow-up and prospective studies are warranted to compare ALKis and to verify our conclusions directly.

Indexed as

Brain NeoplasmsCarcinoma, Non-Small-Cell LungLung NeoplasmsAminopyridinesAnaplastic Lymphoma KinaseBayes TheoremCarbazolesCrizotinibHumansLactamsOrganophosphorus CompoundsProtein Kinase InhibitorsPyrazolesPyrimidinesSulfonesAminopyridinesAnaplastic Lymphoma KinasebrigatinibCarbazolesceritinibCrizotinibLactamslorlatinibOrganophosphorus CompoundsProtein Kinase InhibitorsPyrazolesPyrimidinesSulfonesALK inhibitorBayesiannetwork meta-analysisnon-small cell lung cancer

Identifiers

PMID37334877
PMCPMC10469807
OpenAlexW4381309462

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.