Clinical efficacy and safety of crizotinib and alectinib in ALK-positive non-small cell lung cancer treatment and predictive value of CEA and CA125 for treatment efficacy

Background: To investigate the clinical efficacy and safety of crizotinib and alectinib in anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) treatment and the predictive value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) for treatment efficacy. Methods: A total of 120 patients with ALK-positive NSCLC were enrolled and randomly assigned to receive crizotinib treatment (54 patients, the control group) or alectinib treatment (66 patients, the research group). Treatment efficacy, adverse reactions, survival, and quality of life of patients were compared between the two groups. Enzyme-linked immunosorbent assay was used to determine the serum CEA and CA125 concentrations and these levels were compared between patients with certain treatment responses or no responses. Receiver operating characteristic curve was used to assess the predictive value of CEA and CA125 for treatment efficacy. Results: The overall disease control rate, overall response rate, and number of 1-year survival patients were substantially higher in the research group compared with the control group. Moreover, the incidence of adverse reactions was significantly lower and progression-free survival and overall survival rates were higher in the research group compared with those in the control group. The area under the curve (AUG) for predicting treatment efficacy was 0.889 for CEA and 0.866 for CA125. Conclusion: Alectinib was clinically more efficacious and safer than crizotinib for ALK-positive NSCLC treatment. Both CEA and CA125 demonstrated excellent predictive value for treatment efficacy.