Canadian consensus: inhibition of ALK-positive tumours in advanced non-small-cell lung cancer Academic Article uri icon

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abstract

  • Anaplastic lymphoma kinase (ALK) is an oncogenic driver in non-small-cell lung cancer (NSCLC). Chromosomal rearrangements involving the ALK gene occur in up to 4% of nonsquamous NSCLC patients and lead to constitutive activation of the ALK signalling pathway. ALK-positive NSCLC is found in relatively young patients, with a median age of 50 years. Patients frequently have brain metastasis.Targeted inhibition of the ALK pathway prolongs progression-free survival in patients with ALK-positive advanced NSCLC. The results of several recent clinical trials confirm the efficacy and safety benefit of crizotinib and ceritinib in this population.Canadian oncologists support the following consensus statement: All patients with advanced nonsquamous nsclc (excluding pure neuroendocrine carcinoma) should be tested for the presence of an ALK rearrangement. If an ALK rearrangement is present, treatment with a targeted ALK inhibitor in the first-line setting is recommended. As patients become resistant to first-generation ALK inhibitors, other treatments, including second-generation ALK inhibitors can be considered.

authors

  • Melosky, B
  • Agulnik, J
  • Albadine, R
  • Banerji, S
  • Bebb, DG
  • Bethune, D
  • Blais, N
  • Butts, C
  • Cheema, P
  • Cheung, P
  • Cohen, V
  • Deschenes, J
  • Ionescu, DN
  • Juergens, Rosalyn
  • Kamel-Reid, S
  • Laurie, SA
  • Liu, G
  • Morzycki, W
  • Tsao, MS
  • Xu, Z
  • Hirsh, V

publication date

  • June 2016