Therapeutic strategies in advanced ALK positive non-small cell lung cancer.

The objective of this paper is to synthesise current knowledge on ALK rearrangement and its impact on the management of advanced NSCLC. Several inhibitors of the tyrosine kinase of ALK (crizotinib, ceritinib, alectinib) have been approved as first line therapies in patients with advanced ALK positive NSCLC, which are associated with a better median progression-free survival than conventional chemotherapy. Unfortunately, the emergence of drug resistance leads to tumor progression. In patients with oligoprogressive disease if local ablative therapy can be effected, continuing with the same ALK tyrosine kinase inhibitor is one option. In patients with progression, clinicians may consider switching to another therapy. Rebiopsy of the tumor or liquid biopsy could be attempted to identify the mechanisms of resistance and to customize ALK-target therapy. The emergence of crizotinib drug resistance has prompted the development of next generation drugs including ceritinb, alectinib, brigatinib and lorlatinib. The ability to quickly develop targeted therapies against specific oncogenic drivers will require close co-operation between pathologists, pulmonologists and oncologists in the future to keep pace with drug discoveries and to define optimal therapeutic strategies. PMID: 31727555 [PubMed - as supplied by publisher]
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research

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Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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Source: Case Reports in Oncology - Category: Cancer & Oncology Source Type: research
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Source: In Vivo - Category: Research Authors: Tags: Clinical Studies Source Type: research
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Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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Source: Asbestos and Mesothelioma News - Category: Environmental Health Authors: Source Type: news
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Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
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Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
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Source: Investigational New Drugs - Category: Drugs & Pharmacology Source Type: research
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Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
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Source: Clinical Imaging - Category: Radiology Authors: Tags: Body Imaging Source Type: research
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