Prognostic analysis and development of a prognostic model for EML4-ALK-positive lung cancer patients treated with ALK-TKIs.
[OBJECTIVE] This study aimed to investigate prognostic factors and establish prognostic models for EML4-ALK-positive non-small cell lung cancer (NSCLC) patients receiving ALK tyrosine kinase inhibitor
- 95% CI 25.43-36.52
- HR 2.15
APA
Liu R, Su C, et al. (2026). Prognostic analysis and development of a prognostic model for EML4-ALK-positive lung cancer patients treated with ALK-TKIs.. Frontiers in medicine, 13, 1760300. https://doi.org/10.3389/fmed.2026.1760300
MLA
Liu R, et al.. "Prognostic analysis and development of a prognostic model for EML4-ALK-positive lung cancer patients treated with ALK-TKIs.." Frontiers in medicine, vol. 13, 2026, pp. 1760300.
PMID
42023107
Abstract
[OBJECTIVE] This study aimed to investigate prognostic factors and establish prognostic models for EML4-ALK-positive non-small cell lung cancer (NSCLC) patients receiving ALK tyrosine kinase inhibitors (TKIs) treatment.
[METHODS] We retrospectively analyzed 114 ALK-positive NSCLC patients treated at our institution from January 2020 to January 2024. Clinical data, laboratory results, imaging findings, and follow-up records were collected. Progression-free survival (PFS) and overall survival (OS) served as primary endpoints. Statistical methods included Kaplan-Meier analysis, Cox regression modeling, and nomogram construction (70% training set, 30% validation cohort). Model performance was evaluated using Harrell's C-index, calibration curves, and time-dependent receiver operating characteristic (ROC) analysis.
[RESULTS] The median PFS was 30.97 months (95% CI: 25.43-36.52), while median OS was not reached. Multivariate analysis identified four independent PFS predictors: brain metastasis (HR = 2.15, = 0.008), central lesion location (HR = 1.89, = 0.013), tumor diameter >3 cm (HR = 1.76, = 0.022), and lymphocyte-to-monocyte ratio ≤2.26 (HR = 1.92, = 0.011). For OS, significant factors included brain metastasis (HR = 2.87, = 0.002), CYFRA21-1 level (HR = 1.65, = 0.028), and LMR (HR = 2.04, = 0.007). The developed nomograms demonstrated good prognostic accuracy, with validation cohort C-indices of 0.73 (PFS) and 0.75 (OS). Time-dependent AUCs for 3-year PFS and 4-year OS prognostic were 0.79 and 0.78, respectively.
[CONCLUSION] Our study established that brain metastasis status, tumor characteristics, and systemic inflammatory markers significantly impact clinical outcomes in ALK-positive NSCLC patients undergoing TKI therapy. The developed prognostic models show satisfactory prognostic performance and may assist in clinical decision-making and patient stratification. These findings warrant further validation in prospective, multicenter studies.
[METHODS] We retrospectively analyzed 114 ALK-positive NSCLC patients treated at our institution from January 2020 to January 2024. Clinical data, laboratory results, imaging findings, and follow-up records were collected. Progression-free survival (PFS) and overall survival (OS) served as primary endpoints. Statistical methods included Kaplan-Meier analysis, Cox regression modeling, and nomogram construction (70% training set, 30% validation cohort). Model performance was evaluated using Harrell's C-index, calibration curves, and time-dependent receiver operating characteristic (ROC) analysis.
[RESULTS] The median PFS was 30.97 months (95% CI: 25.43-36.52), while median OS was not reached. Multivariate analysis identified four independent PFS predictors: brain metastasis (HR = 2.15, = 0.008), central lesion location (HR = 1.89, = 0.013), tumor diameter >3 cm (HR = 1.76, = 0.022), and lymphocyte-to-monocyte ratio ≤2.26 (HR = 1.92, = 0.011). For OS, significant factors included brain metastasis (HR = 2.87, = 0.002), CYFRA21-1 level (HR = 1.65, = 0.028), and LMR (HR = 2.04, = 0.007). The developed nomograms demonstrated good prognostic accuracy, with validation cohort C-indices of 0.73 (PFS) and 0.75 (OS). Time-dependent AUCs for 3-year PFS and 4-year OS prognostic were 0.79 and 0.78, respectively.
[CONCLUSION] Our study established that brain metastasis status, tumor characteristics, and systemic inflammatory markers significantly impact clinical outcomes in ALK-positive NSCLC patients undergoing TKI therapy. The developed prognostic models show satisfactory prognostic performance and may assist in clinical decision-making and patient stratification. These findings warrant further validation in prospective, multicenter studies.
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