Current approaches in diagnosis and treatment of ALK-positive non-small-cell lung cancer
Keywords:ALK-positive non-small-cell lung cancer, Tyr-kinase inhibitors, ALK inhibitors, target agents, alectinib, crizotinib
Background. ALK-positive non-small-cell lung cancer (NSCLC) is observed in approximately 3–5 % out of all types of lung cancer. However, its incidence has increased in recent years. This can be caused by the development of diagnostic methods, such as immunohistochemistry testing, which becomes more routine now. There is no longer any doubt that targeted drugs should be used in the first line of treatment. Materials and methods. This article deals with the data from 12 clinical trials, recommendations of NCCN (National Comprehensive Cancer Network), ESMO (European Society of Medical Oncology) and the PubMed search resource. Results. Alectinib is proved to be first choice of ALK-positive NSCLC treatment as it has been reported to be superior over chemotherapy (7.1 against 1.6 months ALUR) as well as crizotinib (20.3 against 10.2 months J-ALEX) in terms of progression-free survival and intracranial efficacy and by far safer to other agents including ceritinib. Conclusions. Thus, ALK inhibitors are safe and effective treatment option in ALK-positive non-small-cell lung cancer. Moreover, ALK inhibitors have achieved better results in prolonging the progression-free survival and improving the quality of life in comparison to chemotherapy. Next generation agents, in particular alectinib and brigatinib are safer and more effective intra-cranially and can be preferred as first option.
Muhammad Khan, Jie Lin, Guixiang Liao, Yunhong Tian, Yingying Liang, Rong Li, Mengzhong Liu, Yawei Yuan. ALK Inhibitors in the Treatment of ALK Positive NSCLC. 2019.
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