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Review

Optimal Care for Patients with Anaplastic Lymphoma Kinase (ALK)–Positive Non–Small Cell Lung Cancer: A Review on the Role and Utility of ALK Inhibitors

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Pages 6615-6628 | Published online: 30 Jul 2020

References

  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30. doi:10.3322/caac.2159031912902
  • Pikor LA, Ramnarine VR, Lam S, Lam WL. Genetic alterations defining NSCLC subtypes and their therapeutic implications. Lung Cancer. 2013;82(2):179–189. doi:10.1016/j.lungcan.2013.07.02524011633
  • Petersen I. The morphological and molecular diagnosis of lung cancer. Dtsch Arztebl Int. 2011;108(31–32):525–531. doi:10.3238/arztebl.2011.052521886665
  • Khan M, Lin J, Liao G, et al. ALK inhibitors in the treatment of ALK positive NSCLC. Front Oncol. 2019;8(557). doi:10.3389/fonc.2018.00557.
  • Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244–285. doi:10.1097/JTO.0b013e318206a22121252716
  • Paez JG, Janne PA, Lee JC, et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004;304(5676):1497–1500. doi:10.1126/science.109931415118125
  • Midha A, Dearden S, McCormack R. EGFR mutation incidence in non-small-cell lung cancer of adenocarcinoma histology: a systematic review and global map by ethnicity (mutMapII). Am J Cancer Res. 2015;5(9):2892–2911.26609494
  • Sasaki T, Rodig SJ, Chirieac LR, Janne PA. The biology and treatment of EML4-ALK non-small cell lung cancer. Eur J Cancer. 2010;46(10):1773–1780. doi:10.1016/j.ejca.2010.04.00220418096
  • Xu H, Ma D, Yang G, et al. Sequential therapy according to distinct disease progression patterns in advanced ALK-positive non-small-cell lung cancer after crizotinib treatment. Chin J Cancer Res. 2019;31(2):349–356. doi:10.21147/j.issn.1000-9604.2019.02.0931156305
  • Yang L, Ling Y, Guo L, et al. Detection of ALK translocation in non-small cell lung carcinoma (NSCLC) and its clinicopathological significance using the ventana immunohistochemical staining method: A single-center large-scale investigation of 1504 Chinese Han patients. Chin J Cancer Res. 2016;28(5):495–502. doi:10.21147/j.issn.1000-9604.2016.05.0427877008
  • Verzura M, Batagelj E, Bagnes C, et al. Analysis of EML4-ALK rearrangement in non-small cell lung cancer in Argentina. Ann Diagn Pathol. 2018;34:77–81. doi:10.1016/j.anndiagpath.2018.02.00929661733
  • Solomon B, Lovly C. Anaplastic lymphoma kinase (ALK) fusion oncogene positive non-small cell lung cancer In: Lilenbaum RC, editor. Uptodate. Waltham, MA: UpToDate Accessed 75, 2020.
  • Chia PL, Mitchell P, Dobrovic A, John T. Prevalence and natural history of ALK positive non-small-cell lung cancer and the clinical impact of targeted therapy with ALK inhibitors. Clin Epidemiol. 2014;6:423–432. doi:10.2147/CLEP.S6971825429239
  • Takahashi T, Sonobe M, Kobayashi M, et al. Clinicopathologic features of non-small-cell lung cancer with EML4-ALK fusion gene. Ann Surg Oncol. 2010;17(3):889–897. doi:10.1245/s10434-009-0808-720183914
  • Inamura K, Takeuchi K, Togashi Y, et al. EML4-ALK fusion is linked to histological characteristics in a subset of lung cancers. J Thorac Oncol. 2008;3(1):13–17. doi:10.1097/JTO.0b013e31815e8b6018166835
  • Bauer TM, Felip E, Solomon BJ, et al. Clinical management of adverse events associated with lorlatinib. Oncologist. 2019;24(8):1103–1110. doi:10.1634/theoncologist.2018-038030890623
  • Patel A, Batra U, Prasad KT, et al. Real world experience of treatment and outcome in ALK-rearranged metastatic nonsmall cell lung cancer: A multicenter study from India. Curr Probl Cancer. 2020;44(3):100571. doi:10.1016/j.currproblcancer.2020.10057132234264
  • Shaw AT, Yeap BY, Mino-Kenudson M, et al. Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK. J Clin Oncol. 2009;27(26):4247–4253. doi:10.1200/JCO.2009.22.699319667264
  • Morris SW, Kirstein MN, Valentine MB, et al. Fusion of a kinase gene, ALK, to a nucleolar protein gene, NPM, in non-hodgkin’s lymphoma. Science. 1994;263(5151):1281–1284. doi:10.1126/science.81221128122112
  • Shaw A, Engelman J. ALK in lung cancer: past, present, and future. J Clin Oncol. 2013;31(8):1105–1111. doi:10.1200/JCO.2012.44.535323401436
  • Soda M, Choi YL, Enomoto M, et al. Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. Nature. 2007;448(7153):561–566. doi:10.1038/nature0594517625570
  • Rikova K, Guo A, Zeng Q, et al. Global survey of phosphotyrosine signaling identifies oncogenic kinases in lung cancer. Cell. 2007;131(6):1190–1203. doi:10.1016/j.cell.2007.11.02518083107
  • Gandhi S, Chen H, Zhao Y, Dy GK. First-line treatment of advanced ALK-positive non-small-cell lung cancer. Lung Cancer (Auckl). 2015;6:71–82. doi:10.2147/LCTT.S6349128210152
  • Weickhardt AJ, Aisner DL, Franklin WA, et al. Diagnostic assays for identification of anaplastic lymphoma kinase-positive non-small cell lung cancer. Cancer. 2013;119(8):1467–1477. doi:10.1002/cncr.2791323280244
  • Ou SHI, Azada M, Hsiang DJ, et al. Next-generation sequencing reveals a novel NSCLC ALK f1174v mutation and confirms ALK G1202R mutation confers high-level resistance to alectinib (CH5424802/RO5424802) in ALK-rearranged NSCLC patients who progressed on crizotinib. J Thorac Oncol. 2014;9(4):549–553. doi:10.1097/JTO.000000000000009424736079
  • Kwak EL, Bang YJ, Camidge DR, et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med. 2010;363(18):1693–1703. doi:10.1056/NEJMoa100644820979469
  • Shaw AT, Kim DW, Nakagawa K, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med. 2013;368(25):2385–2394. doi:10.1056/NEJMoa121488623724913
  • Kazandjian D, Blumenthal GM, Chen H-Y, et al. FDA approval summary: crizotinib for the treatment of metastatic non-small cell lung cancer with anaplastic lymphoma kinase rearrangements. Oncologist. 2014;19(10):e5–11. doi:10.1634/theoncologist.2014-024125170012
  • Solomon BJ, Mok T, Kim DW, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med. 2014;371(23):2167–2177. doi:10.1056/NEJMoa140844025470694
  • Chuang JC, Neal JW. Crizotinib as first line therapy for advanced ALK-positive non-small cell lung cancers. Transl Lung Cancer Res. 2015;4(5):639–641. doi:10.3978/j.issn.2218-6751.2015.03.0626629437
  • Paz-Ares LG, de Marinis F, Dediu M, et al. Paramount: final overall survival results of the phase III study of maintenance pemetrexed versus placebo immediately after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Clin Oncol. 2013;31(23):2895–2902. doi:10.1200/JCO.2012.47.110223835707
  • Rothenstein JM, Chooback N. ALK inhibitors, resistance development, clinical trials. Curr Oncol. 2018;25(Suppl 1):S59–S67. doi:10.3747/co.25.376029910648
  • Lin J, Riely G, Shaw A. Targeting ALK: precision medicine takes on drug resistance. Cancer Discov. 2017;7(2):137–155. doi:10.1158/2159-8290.CD-16-112328122866
  • Gainor JF, Dardaei L, Yoda S, et al. Molecular mechanisms of resistance to first- and second-generation ALK inhibitors in ALK-rearranged lung cancer. Cancer Discov. 2016;6(10):1118–1133. doi:10.1158/2159-8290.CD-16-059627432227
  • Dagogo-Jack I, Shaw AT. Crizotinib resistance: implications for therapeutic strategies. Ann Oncol. 2016;27 Suppl 3:iii42–iii50. doi:10.1093/annonc/mdw30527573756
  • Camidge DR, Bang YJ, Kwak EL, et al. Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer: updated results from a phase I study. Lancet Oncol. 2012;13(10):1011–1019. doi:10.1016/S1470-2045(12)70344-322954507
  • Solomon BJ, Cappuzzo F, Felip E, et al. Intracranial efficacy of crizotinib versus chemotherapy in patients with advanced ALK-positive non-small-cell lung cancer: results from profile 1014. J Clin Oncol. 2016;34(24):2858–2865. doi:10.1200/JCO.2015.63.588827022118
  • Costa DB, Shaw AT, Ou SH, et al. Clinical experience with crizotinib in patients with advanced ALK-rearranged non-small-cell lung cancer and brain metastases. J Clin Oncol. 2015;33(17):1881–1888. doi:10.1200/JCO.2014.59.053925624436
  • Toyokawa G, Seto T, Takenoyama M, Ichinose Y. Insights into brain metastasis in patients with ALK+ lung cancer: is the brain truly a sanctuary? Cancer Metastasis Rev. 2015;34(4):797–805. doi:10.1007/s10555-015-9592-y26342831
  • Klempner SJ, Ou SH. Anaplastic lymphoma kinase inhibitors in brain metastases from ALK+ non-small cell lung cancer: hitting the target even in the CNS. Chin Clin Oncol. 2015;4(2):20.26112806
  • Ou SH. Crizotinib: A novel and first-in-class multitargeted tyrosine kinase inhibitor for the treatment of anaplastic lymphoma kinase rearranged non-small cell lung cancer and beyond. Drug Des Devel Ther. 2011;5:471–485. doi:10.2147/DDDT.S19045
  • Costa DB, Kobayashi S, Pandya SS, et al. CSF concentration of the anaplastic lymphoma kinase inhibitor crizotinib. J Clin Oncol. 2011;29(15):e443–e445. doi:10.1200/JCO.2010.34.131321422405
  • Jain RK, Chen H. Spotlight on brigatinib and its potential in the treatment of patients with metastatic ALK-positive non-small cell lung cancer who are resistant or intolerant to crizotinib. Lung Cancer (Auckl). 2017;8:169–177. doi:10.2147/LCTT.S12650729075144
  • Kaneda H, Okamoto I, Nakagawa K. Rapid response of brain metastasis to crizotinib in a patient with ALK rearrangement-positive non-small-cell lung cancer. J Thorac Oncol. 2013;8(4):e32–e33. doi:10.1097/JTO.0b013e318284377123486271
  • Santarpia M, Daffina MG, D’Aveni A, et al. Spotlight on ceritinib in the treatment of ALK+ NSCLC: design, development and place in therapy. Drug Des Devel Ther. 2017;11:2047–2063. doi:10.2147/DDDT.S113500
  • Friboulet L, Li N, Katayama R, et al. The ALK inhibitor ceritinib overcomes crizotinib resistance in non-small cell lung cancer. Cancer Discov. 2014;4(6):662–673. doi:10.1158/2159-8290.CD-13-084624675041
  • Massarelli E, Papadimitrakopoulou V. Ceritinib for the treatment of late-stage (metastatic) non–small cell lung cancer. Clin Cancer Res. 2015;21(4):670–674. doi:10.1158/1078-0432.CCR-14-129125564153
  • Shaw AT, Kim DW, Mehra R, et al. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014;370(13):1189–1197. doi:10.1056/NEJMoa131110724670165
  • Kim DW, Mehra R, Tan DSW, et al. Activity and safety of ceritinib in patients with ALK-rearranged non-small-cell lung cancer (ASCEND-1): updated results from the multicentre, open-label, phase I trial. Lancet Oncol. 2016;17(4):452–463. doi:10.1016/S1470-2045(15)00614-226973324
  • Mok T, Spigel D, Felip E, et al. ASCEND-2: A single-arm, open-label, multicenter phase ii study of ceritinib in adult patients (pts) with ALK-rearranged (ALK+) non-small cell lung cancer (NSCLC) previously treated with chemotherapy and crizotinib (crz). J Clin Oncol. 2015;33(15_suppl):8059. doi:10.1200/jco.2015.33.15_suppl.8059
  • Shaw AT, Kim TM, Crino L, et al. Ceritinib versus chemotherapy in patients with ALK-rearranged non-small-cell lung cancer previously given chemotherapy and crizotinib (ASCEND-5): A randomised, controlled, open-label, Phase 3 trial. Lancet Oncol. 2017;18(7):874–886. doi:10.1016/S1470-2045(17)30339-X28602779
  • Soria JC, Tan DSW, Chiari R, et al. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): A randomised, open-label, phase 3 study. Lancet. 2017;389(10072):917–929. doi:10.1016/S0140-6736(17)30123-X28126333
  • Cho BC, Kim DW, Bearz A, et al. ASCEND-8: A randomized Phase 1 study of ceritinib, 450 mg or 600 mg, taken with a low-fat meal versus 750 mg in fasted state in patients with anaplastic lymphoma kinase (ALK)-rearranged metastatic non-small cell lung cancer (NSCLC). J Thorac Oncol. 2017;12(9):1357–1367. doi:10.1016/j.jtho.2017.07.00528729021
  • Cho BC, Obermannova R, Bearz A, et al. Efficacy and safety of ceritinib (450 mg/d or 600 mg/d) with food versus 750-mg/d fasted in patients with ALK receptor tyrosine kinase (ALK)-positive NSCLC: primary efficacy results from the ASCEND-8 study. J Thorac Oncol. 2019;14(7):1255–1265. doi:10.1016/j.jtho.2019.03.00230851442
  • European Society for Medical Oncology. Ceritinib targets brain metastases in patients with ALK-positive NSCLC. Available from: https://www.esmo.org/oncology-news/Ceritinib-Targets-Brain-Metastases-in-Patients-with-ALK-positive-NSCLC. Accessed 75, 2020.
  • Chow LQ, Barlesi F, Bertino EM, et al. Results of the ASCEND-7 phase II study evaluating ALK inhibitor (ALKi) ceritinib in patients (pts) with ALK+ non-small cell lung cancer (NSCLC) metastatic to the brain. Ann Oncol. 2019;30(Supplement_5):v602–v603. doi:10.1093/annonc/mdz260
  • Kinoshita K, Asoh K, Furuichi N, et al. Design and synthesis of a highly selective, orally active and potent anaplastic lymphoma kinase inhibitor (CH5424802). Bioorg Med Chem. 2012;20(3):1271–1280. doi:10.1016/j.bmc.2011.12.02122225917
  • Kodama T, Tsukaguchi T, Yoshida M, Kondoh O, Sakamoto H. Selective ALK inhibitor alectinib with potent antitumor activity in models of crizotinib resistance. Cancer Lett. 2014;351(2):215–221. doi:10.1016/j.canlet.2014.05.02024887559
  • Ou SH, Janne PA, Bartlett CH, et al. Clinical benefit of continuing ALK inhibition with crizotinib beyond initial disease progression in patients with advanced ALK-positive NSCLC. Ann Oncol. 2014;25(2):415–422. doi:10.1093/annonc/mdt57224478318
  • Seto T, Kiura K, Nishio M, et al. CH5424802 (RO5424802) for patients with ALK-rearranged advanced non-small-cell lung cancer (af-001jp study): A single-arm, open-label, phase 1–2 study. Lancet Oncol. 2013;14(7):590–598. doi:10.1016/S1470-2045(13)70142-623639470
  • Tamura T, Kiura K, Seto T, et al. Three-year follow-up of an alectinib phase I/II study in ALK-positive non-small-cell lung cancer: af-001jp. J Clin Oncol. 2017;35(14):1515–1521. doi:10.1200/JCO.2016.70.574928296581
  • Gadgeel SM, Gandhi L, Riely GJ, et al. Safety and activity of alectinib against systemic disease and brain metastases in patients with crizotinib-resistant ALK-rearranged non-small-cell lung cancer (af-002jg): results from the dose-finding portion of a phase 1/2 study. Lancet Oncol. 2014;15(10):1119–1128. doi:10.1016/S1470-2045(14)70362-625153538
  • Ou SH, Ahn JS, De Petris L, et al. Alectinib in crizotinib-refractory ALK-rearranged non-small-cell lung cancer: A phase II global study. J Clin Oncol. 2016;34(7):661–668. doi:10.1200/JCO.2015.63.944326598747
  • Shaw AT, Gandhi L, Gadgeel S, et al. Alectinib in ALK-positive, crizotinib-resistant, non-small-cell lung cancer: A single-group, multicentre, Phase 2 trial. Lancet Oncol. 2016;17(2):234–242. doi:10.1016/S1470-2045(15)00488-X26708155
  • Hida T, Nokihara H, Kondo M, et al. Alectinib versus crizotinib in patients with ALK-positive non-small-cell lung cancer (J-ALEX): an open-label, randomised phase 3 trial. Lancet. 2017;390(10089):29–39. doi:10.1016/S0140-6736(17)30565-228501140
  • Seto T, Nishio M, Hida T, et al. Final PFS analysis and safety data from the phase III J-ALEX study of alectinib (alc) vs. crizotinib (crz) in ALK-inhibitor naïve ALK-positive non-small cell lung cancer (ALK+ NSCLC). J Clin Oncol. 2019;37(15_suppl):9092. doi:10.1200/JCO.2019.37.15_suppl.9092
  • Peters S, Camidge DR, Shaw AT, et al. Alectinib versus crizotinib in untreated ALK-positive non-small-cell lung cancer. N Engl J Med. 2017;377(9):829–838. doi:10.1056/NEJMoa170479528586279
  • Camidge DR, Dziadziuszko R, Peters S, et al. Updated efficacy and safety data and impact of the EML4-ALK fusion variant on the efficacy of alectinib in untreated ALK-positive advanced non-small cell lung cancer in the global phase III ALEX study. J Thorac Oncol. 2019;14(7):1233–1243. doi:10.1016/j.jtho.2019.03.00730902613
  • Gadgeel SM, Shaw AT, Govindan R, et al. Pooled analysis of CNS response to alectinib in two studies of pretreated patients with ALK-positive non-small-cell lung cancer. J Clin Oncol. 2016;34(34):4079–4085. doi:10.1200/JCO.2016.68.463927863201
  • Mok TSK, Shaw AT, Camidge RD, et al. The updated OS and safety data from the randomised, phase III ALEX study of alectinib (alc) versus crizotinib (crz) in untreated advanced ALK+ NSCLC. Ann Oncol. 2019;30(Supplement_5):v607. doi:10.1093/annonc/mdz260.006
  • Dagogo-Jack I, Rooney M, Lin JJ, et al. Treatment with next-generation ALK inhibitors fuels plasma ALK mutation diversity. Clin Cancer Res. 2019;25(22):6662–6670. doi:10.1158/1078-0432.CCR-19-143631358542
  • Huang WS, Liu S, Zou D, et al. Discovery of brigatinib (ap26113), a phosphine oxide-containing, potent, orally active inhibitor of anaplastic lymphoma kinase. J Med Chem. 2016;59(10):4948–4964. doi:10.1021/acs.jmedchem.6b0030627144831
  • Kim DW, Tiseo M, Ahn MJ, et al. Brigatinib in patients with crizotinib-refractory anaplastic lymphoma kinase-positive non-small-cell lung cancer: A randomized, multicenter phase II trial. J Clin Oncol. 2017;35(22):2490–2498. doi:10.1200/JCO.2016.71.590428475456
  • Uchibori K, Inase N, Araki M, et al. Brigatinib combined with anti-EGFR antibody overcomes osimertinib resistance in EGFR-mutated non-small-cell lung cancer. Nat Commun. 2017;8:14768. doi:10.1038/ncomms1476828287083
  • Zhang S, Anjum R, Squillace R, et al. The potent ALK inhibitor brigatinib (ap26113) overcomes mechanisms of resistance to first- and second-generation ALK inhibitors in preclinical models. Clin Cancer Res. 2016;22(22):5527–5538. doi:10.1158/1078-0432.CCR-16-056927780853
  • Gettinger SN, Bazhenova LA, Langer CJ, et al. Activity and safety of brigatinib in ALK-rearranged non-small-cell lung cancer and other malignancies: A single-arm, open-label, phase 1/2 trial. Lancet Oncol. 2016;17(12):1683–1696. doi:10.1016/S1470-2045(16)30392-827836716
  • Lin J, Zhu V, Schoenfeld A, et al. Brigatinib in patients with alectinib-refractory ALK-positive NSCLC. J Thorac Oncol. 2018;13(10):1530–1538. doi:10.1016/j.jtho.2018.06.00529935304
  • Kim ES, Ou S-HI, Barlesi F, et al. Phase 2 study of brigatinib in patients (pts) with anaplastic lymphoma kinase (ALK)−positive, advanced non–small cell lung cancer (NSCLC) that progressed on alectinib or ceritinib. J Clin Oncol. 2019;37(15_suppl):TPS9115. doi:10.1200/JCO.2019.37.15_suppl.TPS9115
  • Camidge DR, Kim HR, Ahn MJ, et al. Brigatinib versus crizotinib in ALK-positive non-small-cell lung cancer. N Engl J Med. 2018;379(21):2027–2039. doi:10.1056/NEJMoa181017130280657
  • Johnson TW, Richardson PF, Bailey S, et al. Discovery of (10r)-7-amino-12-fluoro-2,10,16-trimethyl-15-oxo-10,15,16,17-tetrahydro-2h-8,4-(m etheno)pyrazolo[4,3-h][2,5,11]-benzoxadiazacyclotetradecine-3-carbonitrile (pf-06463922), a macrocyclic inhibitor of anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ros1) with preclinical brain exposure and broad-spectrum potency against ALK-resistant mutations. J Med Chem. 2014;57(11):4720–4744. doi:10.1021/jm500261q24819116
  • Solomon BJ, Besse B, Bauer TM, et al. Lorlatinib in patients with ALK-positive non-small-cell lung cancer: results from a global phase 2 study. Lancet Oncol. 2018;19(12):1654–1667. doi:10.1016/S1470-2045(18)30649-130413378
  • Shaw AT, Felip E, Bauer TM, et al. Lorlatinib in non-small-cell lung cancer with ALK or ROS1 rearrangement: an international, multicentre, open-label, single-arm first-in-man phase 1 trial. Lancet Oncol. 2017;18(12):1590–1599. doi:10.1016/S1470-2045(17)30680-029074098
  • National Comprehensive Cancer Network. Non-small cell lung cancer Guideline. Available from: https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed 75, 2020.
  • Gadgeel SM. Sequencing of ALK inhibitors in ALK+ non-small cell lung cancer. Curr Treat Options Oncol. 2017;18(6):36. doi:10.1007/s11864-017-0479-828534251
  • Crystal A, Shaw A, Sequist L, et al. Patient-derived models of acquired resistance can identify effective drug combinations for cancer. Science. 2014;346(6216):1480–1486. doi:10.1126/science.125472125394791
  • Leighl NB, Page RD, Raymond VM, et al. Clinical utility of comprehensive cell-free DNA analysis to identify genomic biomarkers in patients with newly diagnosed metastatic non-small cell lung cancer. Clin Cancer Res. 2019;25(15):4691–4700. doi:10.1158/1078-0432.CCR-19-062430988079
  • European Society for Medical Oncology. Management of advanced/metastatic NSCLC. Available from: https://www.esmo.org/guidelines/lung-and-chest-tumours/metastatic-non-small-cell-lung-cancer/management-of-advanced-metastatic-nsclc. Accessed 75, 2020.
  • Shaw A, Solomon B, Besse B, et al. ALK Resistance mutations and efficacy of lorlatinib in advanced anaplastic lymphoma kinase-positive non-small-cell lung cancer. J Clin Oncol. 2019;37(16):1370–1379. doi:10.1200/JCO.18.0223630892989
  • Targeted treatment for ALK positive patients who have previously been treated for non-squamous non-small cell lung cancer. Available from: ClinicalTrials.gov. Accessed 75, 2020.
  • Horn L, Infante JR, Reckamp KL, et al. Ensartinib (x-396) in ALK-positive non-small cell lung cancer: results from a first-in-human phase I/II, multicenter study. Clin Cancer Res. 2018;24(12):2771–2779. doi:10.1158/1078-0432.CCR-17-239829563138
  • Spigel DR, Reynolds C, Waterhouse D, et al. Phase 1/2 study of the safety and tolerability of nivolumab plus crizotinib for the first-line treatment of anaplastic lymphoma kinase translocation - positive advanced non-small cell lung cancer (CheckMate 370). J Thorac Oncol. 2018;13(5):682–688. doi:10.1016/j.jtho.2018.02.02229518553
  • Crizotinib in treating patients with stage Ib-IIIa non-small cell lung cancer that has been removed by surgery and ALK fusion mutations (an ALCHEMIST treatment trial). Available from: ClinicalTrials.gov. Accessed 75, 2020.
  • A study comparing adjuvant alectinib versus adjuvant platinum-based chemotherapy in patients with ALK positive non-small cell lung cancer. Available from: ClinicalTrials.gov. Accessed 75, 2020.
  • Evaluating crizotinib in the neoadjuvant setting in patients with non-small cell lung cancer. Available from: ClinicalTrials.gov. Accessed 75, 2020.
  • Neoadjuvant therapy in resectable non-small cell lung cancer stages IIIA. Available from: ClinicalTrials.gov. Accessed 75, 2020.
  • Lovly CM, Iyengar P, Gainor JF. Managing resistance to EFGR- and ALK-targeted therapies. Am Soc Clin Oncol Educ Book. 2017;37:607–618. doi:10.14694/EDBK_17625128561721
  • Katayama R. Therapeutic strategies and mechanisms of drug resistance in anaplastic lymphoma kinase (ALK)-rearranged lung cancer. Pharmacol Ther. 2017;177:1–8. doi:10.1016/j.pharmthera.2017.02.01528185914
  • Tran PN, Klempner SJ. ALK on my mind: alectinib takes an early lead in managing intracranial disease in non-small cell lung cancer with ALK rearrangements. Ann Transl Med. 2017;5(7):173. doi:10.21037/atm.2017.03.4728480209
  • Bauer T, Shaw A, Johnson M, et al. Brain penetration of lorlatinib: cumulative incidences of CNS and non-CNS progression with lorlatinib in patients with previously treated ALK-positive non-small-cell lung cancer. Target Oncol. 2020;15(1):55–65. doi:10.1007/s11523-020-00702-432060867
  • Recondo G, Mezquita L, Facchinetti F, et al. Diverse resistance mechanisms to the third-generation ALK inhibitor lorlatinib in ALK-rearranged lung cancer. Clin Cancer Res. 2020;26(1):242–255. doi:10.1158/1078-0432.CCR-19-110431585938
  • Wilson FH, Johannessen CM, Piccioni F, et al. A functional landscape of resistance to ALK inhibition in lung cancer. Cancer Cell. 2015;27(3):397–408. doi:10.1016/j.ccell.2015.02.00525759024
  • Lovly CM, McDonald NT, Chen H, et al. Rationale for co-targeting IGF-1R and ALK in ALK fusion-positive lung cancer. Nat Med. 2014;20(9):1027–1034. doi:10.1038/nm.366725173427