ArticleTherapeutic advances in medical oncology2026
The efficacy of targeted therapy in ALK-positive non-small-cell lung cancer patients and analysis of MET/PD-L1 expression status.
Article in Therapeutic advances in medical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Anaplastic lymphoma kinase-targeted tyrosine kinase inhibitors (ALK-TKIs) have revolutionized the treatment of non-small-cell lung cancer (NSCLC). However, several key issues remain unresolved. Specifically, the impact of prior chemotherapy on ALK-TKI efficacy is unclear, the impact of MET overexpression on ALK-TKI efficacy remains unclear, and the dynamic changes in programmed death ligand 1 (PD-L1) expression during the development of TKI resistance are not fully understood. Objective: This study aimed to evaluate the efficacy of ALK-TKIs across different treatment lines, analyze the impact of MET expression on treatment outcomes, and investigate changes in PD-L1 expression before and after the development of resistance. Design: Retrospective cohort study. Methods: A retrospective analysis was conducted on 259 patients with ALK-positive NSCLC treated at Zhejiang Cancer Hospital between 2011 and 2022 to compare the efficacy of ALK-TKIs administered as first-line therapy versus after chemotherapy. Immunohistochemical staining was used to assess MET and PD-L1 expression. Survival analysis was performed using the Kaplan-Meier method and the log-rank test. Results: Crizotinib showed no significant difference in progression-free survival (PFS) or overall survival (OS) between first-line and post-chemotherapy use (PFS: Conclusion: ALK-TKIs have shown a tendency to improve patient survival in both first-line and post-chemotherapy settings. Among patients treated with alectinib, there appears to be a trend toward shorter PFS and OS in those with MET overexpression. In a limited number of matched samples, PD-L1 expression did not change significantly after TKI resistance, although a slight increase was observed.
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