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- Title
Sustained Improvement in the Management of Patients with Non-Small-Cell Lung Cancer (NSCLC) Harboring ALK Translocation: Where Are We Running?
- Authors
Spitaleri, Gianluca; Trillo Aliaga, Pamela; Attili, Ilaria; Del Signore, Ester; Corvaja, Carla; Corti, Chiara; Crimini, Edoardo; Passaro, Antonio; de Marinis, Filippo
- Abstract
ALK translocation amounts to around 3–7% of all NSCLCs. The clinical features of ALK+ NSCLC are an adenocarcinoma histology, younger age, limited smoking history, and brain metastases. The activity of chemotherapy and immunotherapy is modest in ALK+ disease. Several randomized trials have proven that ALK inhibitors (ALK-Is) have greater efficacy with respect to platinum-based chemotherapy and that second/third generation ALK-Is are better than crizotinib in terms of improvements in median progression-free survival and brain metastases management. Unfortunately, most patients develop acquired resistance to ALK-Is that is mediated by on- and off-target mechanisms. Translational and clinical research are continuing to develop new drugs and/or combinations in order to raise the bar and further improve the results attained up to now. This review summarizes first-line randomized clinical trials of several ALK-Is and the management of brain metastases with a focus on ALK-I resistance mechanisms. The last section addresses future developments and challenges.
- Subjects
NON-small-cell lung carcinoma; CLINICAL trials; MEDICAL research; PROGRESSION-free survival
- Publication
Current Oncology, 2023, Vol 30, Issue 5, p5072
- ISSN
1198-0052
- Publication type
Article
- DOI
10.3390/curroncol30050384