{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T20:50:51Z","timestamp":1782334251929,"version":"3.54.5"},"reference-count":27,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>ALK rearrangements occur in 5.4% of Brazilian patients with non\u2013small cell lung cancer (NSCLC). Data on treatment patterns, access to ALK inhibitors, and survival outcomes are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS<\/jats:title>\n                    <jats:p>LACOG\/GBOT 1918 is a retrospective, observational study that included patients diagnosed with ALK-positive NSCLC between January 2015 and December 2020 in 12 Brazilian public and private centers. Data were extracted from patient records, including clinic-epidemiologic features, diagnosis, ALK testing methods, treatment patterns, and outcomes. Data were analyzed using descriptive statistical methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 101 patients were enrolled. The median age was 55 years (range, 18-86), and 55.4% were female. Immunohistochemistry was the most frequently used method for ALK testing. The median time from the first symptom to diagnosis was 2 months, from diagnosis to ALK testing 1.7 months, and from diagnosis to treatment initiation 1.7 months. Among patients receiving first-line treatment, only 47.9% received ALK inhibitors (53.9% private\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      22.2% public), with crizotinib being the most used. For second-line treatment, 66.0% of patients received ALK inhibitors, with alectinib being the most used (50%). Most treated patients had access to ALK inhibitors in some line of treatment (83.3% private\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      72.2% public); however, in the public setting, targeted treatment was restricted to first-generation and second-generation ALK inhibitors. The 3-year overall survival (OS) rate was 82.6% (95% CI, 72.6 to 89.2), with a lower 3-year OS in the public setting (61.4% public\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      87.2% private;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0279).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Access to targeted ALK therapy is limited in the public health care system, reflecting poor clinical outcomes. Public health measures are necessary to minimize the differences between these two systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-26-00042","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T19:59:11Z","timestamp":1782331151000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of ALK+ Non\u2013Small Cell Lung Cancer in the Brazilian Public and Private Health Care Systems: A Tale of Inequalities (LACOG\/GBOT 1918)"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6107-5098","authenticated-orcid":true,"given":"Eldsamira","family":"Mascarenhas","sequence":"first","affiliation":[{"name":"Oncologia D\u2019Or Bahia, Salvador, Brazil"},{"name":"Instituto D\u2019Or de Pesquisa e Ensino, Salvador, Brazil"},{"name":"Grupo Brasileiro de Oncologia Tor\u00e1cica (GBOT), Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5939-8071","authenticated-orcid":true,"given":"Ana C. Z.","family":"Gelatti","sequence":"additional","affiliation":[{"name":"Grupo Brasileiro de Oncologia Tor\u00e1cica (GBOT), Porto Alegre, Brazil"},{"name":"Oncoclinicas&amp;Co\u2014Medica Scientia Innovation Research (MEDSIR), Porto Alegre, Brazil"},{"name":"Centro de Pesquisa em Oncologia (CPO) do Hospital S\u00e3o Lucas da PUCRS, Porto Alegre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1154-0227","authenticated-orcid":true,"given":"Tatiane","family":"Montella","sequence":"additional","affiliation":[{"name":"N\u00facleo de Excel\u00eancia em Oncologia Tor\u00e1cica, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7707-8768","authenticated-orcid":true,"given":"Marcelo","family":"Corassa","sequence":"additional","affiliation":[{"name":"A.C. Camargo Cancer Center, S\u00e3o Paulo, Brazil"},{"name":"BP\u2014A Benefici\u00eancia Portuguesa de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5008-8854","authenticated-orcid":true,"suffix":"Jr.","given":"William N.","family":"William","sequence":"additional","affiliation":[{"name":"BP\u2014A Benefici\u00eancia Portuguesa de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Oncoclinicas&amp;Co\u2014Medica Scientia Innovation Research (MEDSIR), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2823-7910","authenticated-orcid":true,"given":"Rosely","family":"Yamamura","sequence":"additional","affiliation":[{"name":"BP\u2014A Benefici\u00eancia Portuguesa de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9539-3094","authenticated-orcid":true,"given":"Clarissa","family":"Baldotto","sequence":"additional","affiliation":[{"name":"Oncologia D'Or Botafogo, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8493-7287","authenticated-orcid":true,"given":"Eduardo H.","family":"Cronemberger","sequence":"additional","affiliation":[{"name":"Centro Regional Integrado de Oncologia (CRIO), Fortaleza, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0641-5683","authenticated-orcid":true,"given":"Aknar F. 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