COMPARING THE EFFICACY OF NEXT-GENERATION ALK INHIBITORS VERSUS CRIZOTINIB IN ALK-POSITIVE NON-SMALL CELL LUNG CANCER: IMPLICATIONS FOR TREATMENT OUTCOMES AND ATHLETIC PERFORMANCE

Abstract

Background: The development of anaplastic lymphoma kinase (ALK) inhibitors marks a significant advancement in treating advanced ALK-positive non-small cell lung cancer (NSCLC). This meta-analysis aims to compare the efficacy of next-generation ALK inhibitors with crizotinib, focusing on their impact on progression-free survival (PFS), objective response rates (ORR), and the implications for athletic performance and recovery. Methods: A systematic search of PubMed and Embase was conducted to identify relevant trials. Summary odds ratios (ORs) for PFS, overall survival (OS), ORR, and adverse effects were analyzed using Review Manager Version 5.3. Results: Six randomized controlled trials comprising ten studies were included. The pooled analysis indicated a significant improvement in PFS for patients treated with next-generation ALK inhibitors compared to those receiving crizotinib (OR = 0.38, 95% CI: 0.32–0.44). This benefit was consistent both in patients with and without measurable CNS lesions at baseline. Next-generation ALK inhibitors also showed a superior ORR (OR = 1.92, 95% CI = 1.51-2.43, P < 0.00001). However, no significant difference was observed in OS (OR = 0.82, 95% CI = 0.65-1.02, P = 0.07) or in the incidence of adverse effects (OR = 0.78, 95% CI = 0.31-1.97, P = 0.60). Conclusion: Next-generation ALK inhibitors not only prolong PFS and improve ORR but also maintain a manageable adverse-event profile, suggesting their potential for better maintaining physical activity and quality of life in athletes undergoing treatment for ALK-positive NSCLC. Further research should focus on long-term survival benefits and specific impacts on physical conditioning and recovery in athletic populations.