Targeting a cure in anaplastic lymphoma kinase-positive non-small cell lung cancer
Bibliographic record
Abstract
In the phase III trial "Alectinib in Resected ALK-Positive Non-Small-Cell Lung Cancer", Wu et al. demonstrated that 2 years of adjuvant alectinib, an anaplastic lymphoma kinase (ALK) inhibitor, was associated with a marked improvement in disease-free survival (DFS) compared to standard adjuvant platinum-based chemotherapy in patients with completely resected stage IB to IIIA [American Joint Committee on Cancer (AJCC) 7 th edition] ALK-positive non-small cell lung cancer (NSCLC) (1).A significant benefit was also seen in central nervous system DFS (CNS-DFS) [hazard ratio (HR) 0.22].Overall survival (OS) data remains immature.These positive results from ALINA are practicechanging and have led to regulatory approvals of alectinib as an adjuvant treatment for early-stage ALK-positive NSCLC.ALINA provides evidence to support the use of adjuvant alectinib, however, the role of chemotherapy in further improving outcomes for ALK-positive patients remains an open question.In the current trial, patients were randomised to receive either 2 years of alectinib 600 mg twice daily or four cycles of platinum-based chemotherapy.Chemotherapy was not allowed in the experimental arm which differs from other adjuvant tyrosine kinase inhibitors (TKIs) trial designs (2-4).Adjuvant platinum doublet chemotherapy is an established standard of care in the management of resected early-stage NSCLC and is associated with a 5% survival benefit (5).From a theoretical
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".