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Emerging treatment for ALK-positive lung cancer

Janaki Sharma1, Vipul Pareek1, Huijie Liu1

  • 1a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA.

Expert Opinion on Emerging Drugs
|April 29, 2016
PubMed
Abstract

Insights

Treatment for ALK-positive non-small cell lung cancer (NSCLC) has advanced, but resistance to ALK inhibitors remains a challenge. Newer therapies and strategies are emerging to overcome resistance and improve patient outcomes.

Area of Science:

  • Oncology
  • Pharmacology
  • Genetics

Background:

  • Lung cancer, particularly non-small cell lung cancer (NSCLC), has a historically poor prognosis.
  • Targetable genetic alterations, such as the anaplastic lymphoma kinase (ALK) fusion oncogene, have revolutionized NSCLC treatment.
  • Approved ALK inhibitors (crizotinib, ceritinib, alectinib) offer improved outcomes for ALK-positive NSCLC patients.

Purpose of the Study:

  • To review emerging treatment options for ALK-positive advanced NSCLC.
  • To discuss strategies for overcoming acquired resistance to ALK inhibitors.
  • To highlight future directions in managing ALK-positive NSCLC.

Main Methods:

  • Review of current literature on ALK-positive NSCLC treatment.
  • Discussion of resistance mechanisms to ALK inhibitors.
  • Exploration of novel therapeutic strategies, including next-generation ALK inhibitors, Hsp90 inhibitors, and immunotherapy.

Main Results:

  • Resistance to ALK inhibitors is an inevitable challenge in ALK-positive NSCLC treatment.
  • Multiple mechanisms of acquired resistance have been identified.
  • Emerging therapies show promise in overcoming resistance and improving outcomes.

Conclusions:

  • Despite advances, challenges persist in ALK-positive NSCLC management, including resistance and limited central nervous system (CNS) activity.
  • Re-biopsy at progression is suggested for personalized treatment strategies.
  • Minimally invasive testing and optimal sequencing of ALK inhibitors require further investigation.
Keywords:
ALK oncogeneNon-small cell lung cancerresistance mechanismstargeted therapytyrosine kinase inhibitors

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