{
  "abstract": "Background: Acquired resistance limits durable control with crizotinib in metastatic ALK-positive non–small cell lung cancer (NSCLC). We characterized residual disease and initial progression patterns and identified predictors of candidates for consolidative stereotactic body radiation therapy (SBRT).\n\nMethods: Patients with stage IV ALK-rearranged NSCLC treated with crizotinib (2017–2024) were retrospectively reviewed. Response was assessed per RECIST v1.1. Initial progression was classified as original-site failure (OF), new-site failure (NF), or combined OF and NF (ONF). SBRT eligibility at maximal response was determined using NRG-BR001 criteria and predefined cranial stereotactic radiotherapy criteria. Predictors of eligibility were evaluated using penalized selection followed by logistic regression.\n\nResults: Sixty patients were analyzed. Median time to maximal response was 3.5 months; 15 (25.0%) met SBRT eligibility criteria. Progression occurred in 83.3% (median time to progression, 14.1 months), and oligoprogression occurred in 56%. Lung (50%) and brain (35.7%) were the most common progression sites; initial failure occurred as OF in 34%, NF in 40%, and ONF in 26%. Notably, among SBRT-eligible patients, 66.7% progressed—most often in the brain (50%) and lung (33.3%)—with failures skewed toward NF (50%) rather than OF (30%) or ONF (20%). Independent predictors of SBRT eligibility were female sex, N0–2 disease, absence of baseline bone metastases, and involvement of < 2 metastatic organs.\n\nConclusions: Progression on crizotinib is frequently oligoprogressive and commonly involves intrathoracic disease, with substantial contributions from both baseline-lesion progression and new-site failure. Consolidative SBRT appears feasible in a subset at maximal response. The identified predictors of SBRT eligibility should be considered exploratory and require external validation in larger prospective cohorts.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12885-026-16600-3.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, China",
    "Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhili Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Zexi Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Lulu Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Mao Sun"
    },
    {
      "affs": [
        0
      ],
      "name": "Jueling Tan"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Wei Zhou"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yongzhong Wu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Dan Tao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2gacyckeztbfq.bib",
  "cited_by": 0,
  "doi": "10.1186/s12885-026-16600-3",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13729667/",
  "id": "2gacyckeztbfq",
  "issns": [
    "1471-2407"
  ],
  "landing_url": "https://doi.org/10.1186/s12885-026-16600-3",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2740|Lung Cancer Treatments and Mutations"
    ]
  ],
  "openalex": "W7197035206",
  "pdf_url": null,
  "pmcid": "PMC13729667",
  "pmid": "42977907",
  "published": "2026-08-07",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/2gacyckeztbfq.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:22Z",
      "native_id": "PMC13729667",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12885-026-16600-3"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Lung Cancer Treatments and Mutations",
      "subfield": "general"
    }
  ],
  "title": "Patterns of failure in metastatic ALK-positive NSCLC treated with crizotinib: implications for consolidative stereotactic body radiotherapy",
  "title_text": "Patterns of failure in metastatic ALK-positive NSCLC treated with crizotinib: implications for consolidative stereotactic body radiotherapy",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:22Z",
  "url": "https://research.draconitic.com/paper/2gacyckeztbfq",
  "venue": "BMC Cancer",
  "versions": []
}