Emerging treatment for ALK-positive lung cancer

Janaki N. Sharma, Vipul Pareek, Huijie Liu, Haiying Cheng

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

ABSTRACT: Introduction: Lung cancer is associated with poor prognosis and limited benefit from chemotherapy. The treatment of non-small cell lung cancer (NSCLC) has been revolutionized by the discovery of targetable genetic alterations, including the ALK fusion oncogene. Areascovered: Three drugs have been approved for clinical use in ALK-positive patients – crizotinib, ceritinib and alectinib. Unfortunately, treatment resistance inevitably develops. Several mechanisms of acquired resistance are reported. In this review, we will discuss emerging treatment options in ALK-positive advanced NSCLC and strategies to overcome resistance mechanisms, including newer generation of ALK inhibitors, Hsp90 inhibitors and immunotherapy. Expertopinion: Tremendous advances have been made in the treatment of ALK-positive lung cancers, but management hurdles still exist, including universal development of resistance to ALK inhibitors and limited CNS activity. Given that specific treatment strategies target distinct patterns of resistance, re-biopsy at the time of progression appears necessary to optimize management. However, there remain many issues in routine clinical application including the burden placed on the patients by serial biopsies and the risks of repeat invasive procedures. Future studies are needed to validate the usage of non- or minimally invasive tests and to determine the optimal orders of utilizing different ALK inhibitors.

Original languageEnglish (US)
Pages (from-to)147-155
Number of pages9
JournalExpert Opinion on Emerging Drugs
Volume21
Issue number2
DOIs
StatePublished - Apr 2 2016

Keywords

  • ALK oncogene
  • Non-small cell lung cancer
  • resistance mechanisms
  • targeted therapy
  • tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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