Real-world evolution of first-line ALK-positive NSCLC management in Spain.

Authors

Virginia Calvo, Jon Zugazagoitia, Elisabet García, Gerardo Villa, Antonio José Montes

Published in

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. Oct 06, 2026. Epub Oct 06, 2026.

Abstract

To describe real-world management of patients with ALK-positive advanced or metastatic NSCLC receiving first-line therapy in Spain, and to assess shifts in treatment patterns following the pricing and reimbursement of lorlatinib for first-line treatment in Spain.
This retrospective, cross-sectional analysis used data from the IQVIA Oncology Dynamics™ database. Patients with ALK-positive advanced or metastatic NSCLC receiving first-line treatment in Spain were included in two cohorts: before (July 2021-June 2022) and after (July 2024-June 2025) lorlatinib introduction. Patient characteristics, molecular profiles, and treatment patterns were described using descriptive statistics.
A total of 342 patients were included. Patient characteristics were generally comparable across cohorts, although a higher disease burden and increased frequency of brain metastases were observed over time. A marked shift in treatment patterns was reported, with lorlatinib use increasing from 2 to 46% and becoming the most frequently prescribed first-line therapy in the later cohort, while alectinib use decreased from 85 to 41%. Among newly treated patients, lorlatinib accounted for 67% of prescriptions in the later cohort. Uptake of next-generation sequencing for molecular testing increased, and radiotherapy use declined over time.
The management of ALK-positive NSCLC in Spain has evolved following the pricing and reimbursement of lorlatinib for first-line treatment in Spain, with changes in treatment selection and molecular testing practices observed in routine clinical settings.

PMID:
42837088
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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