Trial Outcomes & Findings for Real-world Therapy of ALK-positive NSCLC in Sweden: the Sequencing of ALK Tyrosine Kinase Inhibitor Drugs and Their Therapeutic Outcomes Based on Data From National Registers. (NCT NCT04647110)

NCT ID: NCT04647110

Last Updated: 2023-04-06

Results Overview

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. Results were reported for treatment cohort groups based on generation of ALK treatment and were as following: Group A1 = chemotherapy + crizotinib (first generation ALK TKI) + any second (2nd) generation ALK TKI; Group A2 = crizotinib + any 2nd generation ALK TKI; Group B1: chemotherapy + crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group B2 = crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group C1 = chemotherapy + crizotinib + any 2nd generation ALK TKI + lorlatinib (third generation ALK TKI); Group C2: crizotinib + any 2nd generation ALK TKI + lorlatinib and Group D1 = any 2nd generation ALK TKI + any other 2nd generation ALK TKI.

• Recruitment status: COMPLETED
• Target enrollment: 549 participants
• Primary outcome timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)
• Results posted on: 2023-04-06

Participant Flow

Study population included participants aged greater than or equal to 18 years at index date (date of first ALK TKI prescription), with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) who had at least one filled prescription of ALK tyrosine kinase inhibitors (TKI) registered in the Swedish Prescribed Drug Register, between 01-Jan-2012 to 31-Dec-2020. Data of eligible participants were assessed in approximately 3 months of this retrospective observational study.

According to application sent to ethical counsel for this study, it was pre-planned not to report data for those cohorts/groups which had less than (<) 5 participants at the index date. Hence, due to ethical compliance study team ensured results would only be displayed on an aggregate level for reporting arms having greater than or equal to (>=) 5 participants at index date.

Participant milestones

Measure	Participants With No First Line Chemotherapy Participants included in this arm received at least one filled prescription of ALK TKIs in real world practices, with no first line chemotherapy treatment. ALK TKIs were crizotinib, alectinib, brigatinib, ceritinib, or lorlatinib.	Participants With First Line Chemotherapy Participants included in this arm received at least one filled prescription of ALK TKIs in real world practices, along with first line chemotherapy treatment. ALK TKIs were crizotinib, alectinib, brigatinib, ceritinib, or lorlatinib.
Overall Study STARTED	345	204
Overall Study COMPLETED	345	204
Overall Study NOT COMPLETED	0	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Measure	Participants With No First Line Chemotherapy n=345 Participants Participants included in this arm received at least one filled prescription of ALK TKIs in real world practices, with no first line chemotherapy treatment. ALK TKIs were crizotinib, alectinib, brigatinib, ceritinib, or lorlatinib.	Participants With First Line Chemotherapy n=204 Participants Participants included in this arm received at least one filled prescription of ALK TKIs in real world practices, along with first line chemotherapy treatment. ALK TKIs were crizotinib, alectinib, brigatinib, ceritinib, or lorlatinib.	Total n=549 Participants Total of all reporting groups
Age, Continuous	63.08 Years STANDARD_DEVIATION 13.96 • n=345 Participants	63.24 Years STANDARD_DEVIATION 13.28 • n=204 Participants	63.13 Years STANDARD_DEVIATION 13.70 • n=549 Participants
Sex: Female, Male Female	189 Participants n=345 Participants	112 Participants n=204 Participants	301 Participants n=549 Participants
Sex: Female, Male Male	156 Participants n=345 Participants	92 Participants n=204 Participants	248 Participants n=549 Participants
Race and Ethnicity Not Collected	—	—	0 Participants Race and Ethnicity were not collected from any participant.

PRIMARY outcome

Timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure based on generation of ALK treatment.

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. Results were reported for treatment cohort groups based on generation of ALK treatment and were as following: Group A1 = chemotherapy + crizotinib (first generation ALK TKI) + any second (2nd) generation ALK TKI; Group A2 = crizotinib + any 2nd generation ALK TKI; Group B1: chemotherapy + crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group B2 = crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group C1 = chemotherapy + crizotinib + any 2nd generation ALK TKI + lorlatinib (third generation ALK TKI); Group C2: crizotinib + any 2nd generation ALK TKI + lorlatinib and Group D1 = any 2nd generation ALK TKI + any other 2nd generation ALK TKI.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=29 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=71 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=10 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=14 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=5 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 n=9 Participants Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 n=9 Participants Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Overall Survival (OS): Based on Treatment Cohort Groups	—	—	—	—	—	—	—	1.94 Years Interval 1.22 to 3.35	2.30 Years Interval 1.67 to 3.02	4.56 Years Interval 2.41 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants with event.	2.94 Years Interval 2.07 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	5.41 Years Upper and lower limit for 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed.

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. Results were reported based on chemotherapy status.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=345 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=204 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Overall Survival: Based on Chemotherapy Status	—	—	—	—	—	—	—	2.02 Years Interval 1.6 to 2.58	1.44 Years Interval 0.89 to 1.98	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed.

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. In this outcome measure, participants were grouped on basis of their CNS-metastases status.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=520 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=29 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Overall Survival: Based on Central Nervous System (CNS) Metastases Status	—	—	—	—	—	—	—	1.94 Years Interval 1.52 to 2.26	0.61 Years Interval 0.34 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants with event.	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants evaluable for this measure and received only 1 line of ALK TKIs with/ without chemotherapy. Due to ethical compliance, it was pre-planned not to report data for those reporting groups which had \<5 participants at the index date.

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. In this outcome measure, OS was reported for participants who received 1 line of ALK TKI treatment. Reporting arms were based on type of ALK TKI, with or without chemotherapy. ALK TKIs considered were crizotinib, alectinib, ceritinib.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=116 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=105 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=4 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=95 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=41 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 n=5 Participants Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Overall Survival: Based on ALK Sequencing, 1 Line of ALK TKI Treatment	—	—	—	—	—	—	—	0.88 Years Interval 0.6 to 1.08	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.63 Years Interval 0.46 to 0.78	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	0.59 Years Interval 0.44 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants with event.	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. "Overall Number of Participants Analyzed (N)": participants evaluable for this measure and received only 2 lines of ALK TKIs with/ without chemotherapy. Groups with "N" =0: no participants with respective ALK TKI sequencing. Due to ethical compliance, it was pre-planned not to report data for those reporting groups which had \<5 participants at the index date.

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. In this outcome measure OS was reported for participants who received 2 lines of ALK TKI treatment. Reporting arms were based on type of first line ALK TKI treatment and second line of ALK TKI treatment, with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=33 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=38 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=8 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 n=6 Participants Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 n=1 Participants Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib n=1 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy n=9 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy n=2 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy n=18 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy n=2 Participants Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy n=1 Participants Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy n=7 Participants Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy n=2 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Overall Survival: Based on ALK Sequencing, 2 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	—	1.27 Years Interval 1.14 to 1.94	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	—	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	2.69 Years Interval 1.22 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	1.38 Years Interval 0.76 to 2.94	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Median and 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—

PRIMARY outcome

Timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. "Overall Number of Participants Analyzed (N)": participants evaluable for this measure and received only 3 lines of ALK TKIs with/ without chemotherapy. Groups with "N" =0: no participants with respective ALK TKI sequencing. Due to ethical compliance, it was pre-planned not to report data for those reporting groups which had \<5 participants at the index date.

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. In this outcome measure OS was reported for participants who received 3 lines of ALK inhibitor treatment. Reporting arms were based on type of first line ALK TKI treatment, second line of ALK TKI treatment and third line of ALK TKI treatment with or without, chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy n=2 Participants Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=7 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=3 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=11 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=1 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib n=1 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib n=1 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy n=1 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy n=1 Participants Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy n=1 Participants Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy n=3 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy n=6 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy n=2 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Overall Survival: Based on ALK Sequencing, 3 Lines of ALK TKI Treatment	—	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	—	—	—	5.41 Years Upper and lower limit for 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	2.78 Years Interval 2.07 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	4.06 Years Interval 2.41 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants with event.	NA Years Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—

PRIMARY outcome

Timeframe: From index date to the date of death due to any cause or censoring date, during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure and received \>= 4 lines of ALK TKI treatment with or without chemotherapy.

OS was defined as the time from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data). Kaplan-Meier method was used for analysis. In this outcome measure, OS was reported for participants who received >=4 lines of ALK inhibitor treatment with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=8 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=7 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Overall Survival: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	5.49 Years Interval 3.79 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants.	5.27 Years Interval 3.02 to Upper limit for 95% CI could not be estimated because there were insufficient number of participants.	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 5 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants who evaluable for this measure with a follow up of 5 years post index date. Reporting groups with "N" =0 signifies that no participant had a follow up of 5 years post index date.

Results were reported for treatment cohort groups based on generation of ALK treatment and were as following: Group A1 = chemotherapy + crizotinib (first generation ALK TKI) + any second (2nd) generation ALK TKI; Group A2 = crizotinib + any 2nd generation ALK TKI; Group B1: chemotherapy + crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group B2 = crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group C1 = chemotherapy + crizotinib + any 2nd generation ALK TKI + lorlatinib (third generation ALK TKI); Group C2: crizotinib + any 2nd generation ALK TKI + lorlatinib and Group D1 = any 2nd generation ALK TKI + any other 2nd generation ALK TKI.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=16 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=21 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=5 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=2 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=3 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 n=1 Participants Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 5 Years From Index Date: Based on Treatment Cohort Groups	—	—	—	—	—	—	—	6.25 Percentage of participants	9.52 Percentage of participants	40.00 Percentage of participants	50.00 Percentage of participants	66.67 Percentage of participants	100 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 5 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 5 years post index date.

Participants alive after five years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported in this outcome measure. Results were reported based on chemotherapy status.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=61 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=61 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 5 Years From Index Date: Based on Chemotherapy Status	—	—	—	—	—	—	—	16.39 Percentage of participants	16.39 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 5 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 5 years post index date.

Participants alive after five years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported in this outcome measure. Results were reported based on CNS metastases status.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=116 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=6 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 5 Years From Index Date: Based on CNS Metastases Status	—	—	—	—	—	—	—	17.24 Percentage of participants	0.00 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 5 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 5 years post index date. Reporting arm with "Overall Number of Participants Analyzed" = 0, signifies that no participant had a follow up of 5 years post index date.

Participants alive after five years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure, participants who received 1 line of ALK TKI treatment, were reported. Reporting arms were based on type of first line ALK TKI treatment, with or without chemotherapy. ALK TKIs considered were crizotinib, alectinib, ceritinib.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=35 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=32 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 5 Years From Index Date: Based on ALK Sequencing, 1 Line of ALK TKI Treatment	—	—	—	—	—	—	—	11.43 Percentage of participants	—	—	0.00 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 5 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants who evaluable for this measure with a follow up of 5 years post index date. Reporting groups with "N" =0 signifies that no participant had a follow up of 5 years post index date.

Participants alive after five years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure, participants who received 2 lines of ALK TKI treatment, were reported. Reporting arms were based on type of first line ALK TKI treatment and second line of ALK TKI treatment, with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=3 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=18 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy n=2 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy n=14 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 5 Years From Index Date: Based on ALK Sequencing, 2 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	66.67 Percentage of participants	—	0.00 Percentage of participants	—	—	—	—	—	—	0.00 Percentage of participants	—	7.14 Percentage of participants	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 5 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants who evaluable for this measure with a follow up of 5 years post index date. Reporting groups with "N" =0 signifies that no participant had a follow up of 5 years post index date.

Participants alive after five years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure, participants who received 3 lines of ALK TKI treatment. Reporting arms were based on type of first line ALK TKI treatment, second line of ALK TKI treatment, and third line of ALK TKI treatment, with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=1 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=2 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy n=4 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 5 Years From Index Date: Based on ALK Sequencing, 3 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	—	100.00 Percentage of participants	—	50.00 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	25.00 Percentage of participants	—	—

PRIMARY outcome

Timeframe: 5 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 5 years post index date.

Participants alive after five years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure, data is reported for participants who received >=4 lines of ALK inhibitor treatment with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=2 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=5 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 5 Years From Index Date: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	100.00 Percentage of participants	100.00 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 6 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants who evaluable for this measure with a follow up of 6 years post index date. Reporting groups with "N" =0 signifies that no participant had a follow up of 6 years post index date.

Results were reported for treatment cohort groups based on generation of ALK treatment and were as following: Group A1 = chemotherapy + crizotinib (first generation ALK TKI) + any second (2nd) generation ALK TKI; Group A2 = crizotinib + any 2nd generation ALK TKI; Group B1: chemotherapy + crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group B2 = crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group C1 = chemotherapy + crizotinib + any 2nd generation ALK TKI + lorlatinib (third generation ALK TKI); Group C2: crizotinib + any 2nd generation ALK TKI + lorlatinib and Group D1 = any 2nd generation ALK TKI + any other 2nd generation ALK TKI.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=5 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=3 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=1 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=1 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 6 Years From Index Date: Based on Treatment Cohort Groups	—	—	—	—	—	—	—	0.00 Percentage of participants	0.00 Percentage of participants	0.00 Percentage of participants	—	0.00 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 6 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 6 years post index date.

Participants alive after six years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported in this outcome measure. Results were reported based on chemotherapy status.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=20 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=26 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 6 Years From Index Date: Based on Chemotherapy Status	—	—	—	—	—	—	—	10.00 Percentage of participants	3.85 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 6 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 6 years post index date.

Participants alive after six years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported in this outcome measure. Results were reported based on CNS metastases status.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=44 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=2 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 6 Years From Index Date: Based on CNS Metastases Status	—	—	—	—	—	—	—	6.82 Percentage of participants	0.00 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 6 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 6 years post index date. Reporting arm with "Overall Number of Participants Analyzed" = 0, signifies that no participant had a follow up of 6 years post index date.

Participants alive after six years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure, participants who received 1 line of ALK TKI treatment, were reported. Reporting arms were based on type of first line ALK TKI treatment, with or without chemotherapy. ALK TKIs considered were crizotinib, alectinib, ceritinib.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=16 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=16 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 6 Years From Index Date: Based on ALK Sequencing, 1 Line of ALK TKI Treatment	—	—	—	—	—	—	—	12.50 Percentage of participants	—	—	0.00 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 6 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants who evaluable for this measure with a follow up of 6 years post index date. Reporting groups with "N" =0 signifies that no participant had a follow up of 6 years post index date.

Participants alive after six years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure, participants who received 2 lines of ALK TKI treatment, were reported. Reporting arms were based on type of first line ALK TKI treatment and second line of ALK TKI treatment, with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=1 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=2 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy n=5 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 6 Years From Index Date: Based on ALK Sequencing, 2 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	0.00 Percentage of participants	—	0.00 Percentage of participants	—	—	—	—	—	—	—	—	0.00 Percentage of participants	—	—	—	—	—	—	—

PRIMARY outcome

Timeframe: 6 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants who evaluable for this measure with a follow up of 6 years post index date. Reporting groups with "N" =0 signifies that no participant had a follow up of 6 years post index date.

Participants alive after six years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure OS was reported for participants who received 3 lines of ALK inhibitor treatment. Reporting arms were based on type of first line ALK TKI treatment, second line of ALK TKI treatment, and third line of ALK TKI treatment, with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy n=1 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 6 Years From Index Date: Based on ALK Sequencing, 3 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	0.00 Percentage of participants	—	—

PRIMARY outcome

Timeframe: 6 years post index date during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure with a follow up of 6 years post index date.

Participants alive after six years from index date (date of first ALK TKI prescription) to the date of death due to any cause or censoring date (latest available date in data), were reported. In this outcome measure, data is reported for participants who received >=4 lines of ALK inhibitor treatment with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=1 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=3 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Percentage of Participants Alive After 6 Years From Index Date: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment	—	—	—	—	—	—	—	0.00 Percentage of participants	33.33 Percentage of participants	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

SECONDARY outcome

Timeframe: From index date to treatment completion/discontinuation during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure based on generation of ALK treatment.

Duration of treatment was defined as number of days on treatment calculated based on pharmaceutical specialties in Sweden (FASS) recommended dose for filled prescriptions of ALK-inhibitors taking permissible gap and stockpiling into account. Results were reported for treatment cohort groups based on generation of ALK treatment and were as following: Group A1 = chemotherapy + crizotinib (first generation ALK TKI) + any second (2nd) generation ALK TKI; Group A2 = crizotinib + any 2nd generation ALK TKI; Group B1: chemotherapy + crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group B2 = crizotinib + any 2nd generation ALK TKI + any other 2nd generation ALK TKI; Group C1 = chemotherapy + crizotinib + any 2nd generation ALK TKI + lorlatinib (third generation ALK TKI); Group C2: crizotinib + any 2nd generation ALK TKI + lorlatinib and Group D1 = any 2nd generation ALK TKI + any other 2nd generation ALK TKI.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=29 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=71 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=10 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=14 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=5 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 n=9 Participants Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 n=9 Participants Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Duration of Treatment: Based on Treatment Cohort Groups	—	—	—	—	—	—	—	1.66 Years Standard Deviation 1.28	1.86 Years Standard Deviation 1.31	3.37 Years Standard Deviation 1.24	2.45 Years Standard Deviation 1.53	2.56 Years Standard Deviation 1.42	2.72 Years Standard Deviation 1.03	1.36 Years Standard Deviation 0.75	—	—	—	—	—	—	—	—	—	—	—	—

SECONDARY outcome

Timeframe: From index date to treatment completion/discontinuation during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed.

Duration of treatment was defined as number of days on treatment calculated based on pharmaceutical specialties in Sweden (FASS) recommended dose for filled prescriptions of ALK-inhibitors taking permissible gap and stockpiling into account. Results were reported based on chemotherapy status.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=345 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=204 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Duration of Treatment: Based on Chemotherapy Status	—	—	—	—	—	—	—	1.23 Years Standard Deviation 1.28	1.07 Years Standard Deviation 1.28	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

SECONDARY outcome

Timeframe: From index date to treatment completion/discontinuation during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed (N)" signifies participants evaluable for this measure and received only 1 line of ALK TKIs with/ without chemotherapy. Due to ethical compliance, it was pre-planned not to report data for those reporting groups which had \<5 participants at the index date.

Duration of treatment was defined as number of days on treatment calculated based on FASS recommended dose for filled prescriptions of ALK-inhibitors taking permissible gap and stockpiling into account. Reporting arms were based on type of ALK TKI, with or without chemotherapy. ALK TKIs considered were crizotinib, alectinib, ceritinib.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=116 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=105 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=4 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=95 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=41 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 n=5 Participants Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Duration of Treatment: Based on ALK Sequencing, 1 Line of ALK TKI Treatment First Line ALK TKI Treatment Duration	—	—	—	—	—	—	—	0.72 Years Standard Deviation 1.19	0.92 Years Standard Deviation 0.82	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.50 Years Standard Deviation 0.80	0.80 Years Standard Deviation 0.88	1.01 Years Standard Deviation 1.23	—	—	—	—	—	—	—	—	—	—	—	—	—
Duration of Treatment: Based on ALK Sequencing, 1 Line of ALK TKI Treatment Total Sequence Treatment Duration	—	—	—	—	—	—	—	0.72 Years Standard Deviation 1.19	0.92 Years Standard Deviation 0.82	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.50 Years Standard Deviation 0.80	0.80 Years Standard Deviation 0.88	1.01 Years Standard Deviation 1.23	—	—	—	—	—	—	—	—	—	—	—	—	—

SECONDARY outcome

Timeframe: From index date to treatment completion/discontinuation during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. "Overall Number of Participants Analyzed (N)": participants evaluable for this measure and received only 2 lines of ALK TKIs with/ without chemotherapy. Groups with "N" =0: no participants with respective ALK TKI sequencing. Due to ethical compliance, it was pre-planned not to report data for those reporting groups which had \<5 participants at the index date.

Duration of treatment was defined as number of days on treatment calculated based on FASS recommended dose for filled prescriptions of ALK-inhibitors taking permissible gap and stockpiling into account. Reporting arms were based on type of first line ALK TKI treatment, and second line of ALK TKI treatment, with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=33 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=38 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=8 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 n=6 Participants Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 n=1 Participants Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib n=1 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy n=9 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy n=2 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy n=18 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy n=2 Participants Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy n=1 Participants Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy n=7 Participants Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy n=2 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Duration of Treatment: Based on ALK Sequencing, 2 Lines of ALK TKI Treatment First Line ALK TKI Treatment Duration	—	—	—	—	—	—	—	1.01 Years Standard Deviation 0.80	—	0.62 Years Standard Deviation 0.45	0.61 Years Standard Deviation 0.51	—	0.95 Years Standard Deviation 0.62	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	1.42 Years Standard Deviation 1.31	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.81 Years Standard Deviation 0.70	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.50 Years Standard Deviation 0.60	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—
Duration of Treatment: Based on ALK Sequencing, 2 Lines of ALK TKI Treatment Second Line ALK TKI Treatment Duration	—	—	—	—	—	—	—	1.62 Years Standard Deviation 1.07	—	0.58 Years Standard Deviation 0.72	0.55 Years Standard Deviation 0.34	—	0.27 Years Standard Deviation 0.23	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.75 Years Standard Deviation 0.89	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.37 Years Standard Deviation 0.67	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.40 Years Standard Deviation 0.37	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—
Duration of Treatment: Based on ALK Sequencing, 2 Lines of ALK TKI Treatment Total Sequence Treatment Duration	—	—	—	—	—	—	—	2.62 Years Standard Deviation 1.33	—	1.21 Years Standard Deviation 0.86	1.16 Years Standard Deviation 0.51	—	1.22 Years Standard Deviation 0.57	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	2.17 Years Standard Deviation 1.32	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	1.18 Years Standard Deviation 0.99	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.89 Years Standard Deviation 0.64	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—

SECONDARY outcome

Timeframe: From index date to treatment completion/discontinuation during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. "Overall Number of Participants Analyzed (N)": participants evaluable for this measure and received only 3 lines of ALK TKIs with/ without chemotherapy. Groups with "N" =0: no participants with respective ALK TKI sequencing. Due to ethical compliance, it was pre-planned not to report data for those reporting groups which had \<5 participants at the index date.

Duration of treatment was defined as number of days on treatment calculated based on FASS recommended dose for filled prescriptions of ALK-inhibitors taking permissible gap and stockpiling into account. Reporting arms were based on type of first line ALK TKI treatment, second line of ALK TKI treatment, and third line of ALK TKI treatment with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy n=2 Participants Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=7 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 n=3 Participants Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 n=11 Participants Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 n=1 Participants Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib n=1 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib n=1 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy n=1 Participants Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy n=1 Participants Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy n=1 Participants Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy n=3 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy n=6 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy n=2 Participants Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Duration of Treatment: Based on ALK Sequencing, 3 Lines of ALK TKI Treatment Total Sequence Treatment Duration	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	—	—	—	2.88 Years Standard Deviation 1.13	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	2.39 Years Standard Deviation 1.65	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	3.34 Years Standard Deviation 1.01	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—
Duration of Treatment: Based on ALK Sequencing, 3 Lines of ALK TKI Treatment Second Line ALK TKI Treatment Duration	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	—	—	—	1.29 Years Standard Deviation 0.69	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.85 Years Standard Deviation 0.81	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	1.53 Years Standard Deviation 1.31	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—
Duration of Treatment: Based on ALK Sequencing, 3 Lines of ALK TKI Treatment First Line ALK TKI Treatment Duration	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	—	—	—	1.12 Years Standard Deviation 1.13	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.70 Years Standard Deviation 0.38	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	1.12 Years Standard Deviation 0.63	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—
Duration of Treatment: Based on ALK Sequencing, 3 Lines of ALK TKI Treatment Third Line ALK TKI Treatment Duration	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	—	—	—	0.47 Years Standard Deviation 0.37	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.85 Years Standard Deviation 0.90	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—	—	—	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	0.68 Years Standard Deviation 1.07	NA Years Standard Deviation NA Due to ethical compliance data is not reported for reporting arms with \<5 participants at index date.	—

SECONDARY outcome

Timeframe: From index date to treatment completion/discontinuation during data identification period of 9 years (retrieved data assessed in this observational study for approximately 3 months)

Population: Analysis population included all eligible participants whose data were retrieved from Swedish administrative registers and assessed. Here, "Overall Number of Participants Analyzed" signifies participants who were evaluable for this outcome measure and received \>= 4 lines of ALK TKI treatment with or without chemotherapy.

Duration of treatment was defined as number of days on treatment calculated based on FASS recommended dose for filled prescriptions of ALK-inhibitors taking permissible gap and stockpiling into account. In this outcome measure, duration of treatment was reported for participants who received >=4 lines of ALK inhibitor treatment, with or without chemotherapy.

Outcome measures

Measure	Crizotinib + Brigatinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, alectinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, brigatinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK TKI treatment, lorlatinib as second line ALK TKI treatment, ceritinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, lorlatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK TKI treatment, alectinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.	>=4 Lines of ALK TKI n=8 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices.	>=4 Lines of ALK TKI With Chemotherapy n=7 Participants Participants included in this arm received at least 4 different ALK TKIs, in real world practices along with chemotherapy.	Group B1 Participants included in this arm received chemotherapy, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group B2 Participants included in this arm received, crizotinib and any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C1 Participants included in this arm received chemotherapy, crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group C2 Participants included in this arm received crizotinib, any second generation ALK TKI and lorlatinib in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Group D1 Participants included in this arm received any two second generation ALK TKIs in real world practices. Second generation ALK TKIs considered were alectinib, brigatinib, or ceritinib.	Ceritinib + Brigatinib Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices.	Ceritinib + Lorlatinib Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices.	Crizotinib + Alectinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Brigatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Ceritinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and ceritinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Alectinib + Lorlatinib + Chemotherapy Participants included in this arm received alectinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Alectinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and alectinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and brigatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Ceritinib + Lorlatinib + Chemotherapy Participants included in this arm received ceritinib as first line ALK KI treatment and lorlatinib as second line ALK TKI treatment, in real world practices along with chemotherapy.	Crizotinib + Ceritinib + Brigatinib + Chemotherapy Participants included in this arm received crizotinib as first line ALK TKI treatment, ceritinib as second line ALK TKI treatment, brigatinib as third line ALK TKI treatment, in real world practices along with chemotherapy.
Duration of Treatment: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment First Line ALK TKI Treatment Duration	—	—	—	—	—	—	—	1.09 Years Standard Deviation 0.61	1.56 Years Standard Deviation 0.82	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—
Duration of Treatment: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment Second Line ALK TKI Treatment Duration	—	—	—	—	—	—	—	1.01 Years Standard Deviation 0.73	0.73 Years Standard Deviation 0.49	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—
Duration of Treatment: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment Third Line ALK TKI Treatment Duration	—	—	—	—	—	—	—	0.80 Years Standard Deviation 0.63	0.63 Years Standard Deviation 0.56	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—
Duration of Treatment: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment Fourth Line ALK TKI Treatment Duration	—	—	—	—	—	—	—	0.52 Years Standard Deviation 0.48	0.47 Years Standard Deviation 0.50	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—
Duration of Treatment: Based on ALK Sequencing, More Than or Equal to (>=) 4 Lines of ALK TKI Treatment Total Sequence Treatment Duration	—	—	—	—	—	—	—	3.42 Years Standard Deviation 0.98	3.40 Years Standard Deviation 1.76	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—	—

Adverse Events

Participants With No First Line Chemotherapy

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Participants With First Line Chemotherapy

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Pfizer ClinicalTrials.gov Call Center

Pfizer Inc.

Phone: 1-800-718-1021

Email: ClinicalTrials.gov_Inquiries@pfizer.com

Results disclosure agreements

• Principal investigator is a sponsor employee Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from the study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
• Publication restrictions are in place

Restriction type: OTHER