Treatment Patterns, Prognostic Factors and Survival for ALK-Positive Advanced NSCLC In Australia: Results From the Australasian Thoracic Cancers Longitudinal Cohort Study and Biobank (AURORA)

Chazan, G; Alexander, M; Franchini, F; IJzerman M; Shah, R; John, A; Spelman, T; Itchins, M; Pavlakis, N; Nagrial, A; Warburton, L; Bowyer, S; Kao, S; Parakh, S; Solomon, BJ

Author(s): Chazan, G; Alexander, M; Franchini, F; IJzerman M; Shah, R; John, A; Spelman, T; Itchins, M; Pavlakis, N; Nagrial, A; Warburton, L; Bowyer, S; Kao, S; Parakh, S; Solomon, BJ;
Details: Publication Year 2026-02,Volume 7,Issue #2,Page 100924
Journal Title: JTO Clinical and Research Reports
Abstract: INTRODUCTION: Advanced lung cancer has historically been associated with poor survival. However, with the advent of targeted therapies, outcomes are improving. Among patients with ALK-rearranged advanced NSCLC (ALK+ aNSCLC), real-world data on treatment patterns, prognostic factors, and survival in the era of contemporary therapy remain limited. METHODS: We conducted a retrospective observational cohort study using deidentified patient, disease, and outcomes data from the AUstralasian thoRacic cancers lOngitudinal cohoRt study and biobAnk (AURORA; ACTRN12625000038493). Eligible patients were diagnosed with ALK+ aNSCLC between 2006 and 2025. RESULTS: Of the 4776 patients with thoracic malignancies enrolled across eight sites (as of April 2025), 218 met the inclusion criteria-the largest reported Australian cohort of ALK+ aNSCLC. All patients were treated in academic centers. The median age was 55 years; 54% were female, 66% were never-smokers, and 41% had participated in a clinical trial. The median overall survival was 90.8 months (95% CI: 69.8-not reached). Nearly all patients (99%) received an ALK inhibitor; 83% in the first-line setting. Treatment sequences evolved over time. Most (68%) received at least two lines of therapy; 21% received 4 or more lines. Smoking status, age, and Eastern Cooperative Oncology Group Performance Status were prognostically associated with survival. CONCLUSION: This study highlights the remarkable survival achievable in the real-world setting for some patients with ALK+ aNSCLC, compared with historical cohorts. Several clinical factors associated with survival were identified. Larger studies are needed to investigate how treatment sequences may be optimized to further improve survival outcomes.
Publisher: Elsevier
Keywords: ALK+ lung cancer; Prognostic factors; Real-world; Treatment sequence
Research Division(s): Clinical Discovery and Translation
PubMed ID: 41626535
Publisher's Version: https://doi.org/10.1016/j.jtocrr.2025.100924
Open Access at Publisher's Site: https://doi.org/10.1016/j.jtocrr.2025.100924
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-02-09 09:18:21

Last Modified: 2026-02-09 09:23:24