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2015 ; 7
(5
): 274-90
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Treating patients with ALK-positive non-small cell lung cancer: latest evidence
and management strategy
#MMPMID26327925
Liao BC
; Lin CC
; Shih JY
; Yang JC
Ther Adv Med Oncol
2015[Sep]; 7
(5
): 274-90
PMID26327925
show ga
Rearrangements in anaplastic lymphoma kinase (ALK) gene and echinoderm
microtubule-associated protein-like 4 (EML4) gene were first described in a small
portion of patients with non-small cell lung cancer (NSCLC) in 2007. Fluorescence
in situ hybridization is used as the diagnostic test for detecting an EML4-ALK
rearrangement. Crizotinib, an ALK inhibitor, is effective in treating advanced
ALK-positive NSCLC, and the US Food and Drug Administration approved it for
treating ALK-positive NSCLC in 2011. Several mechanisms of acquired resistance to
crizotinib have recently been reported. Second-generation ALK inhibitors were
designed to overcome these resistance mechanisms. Two of them, ceritinib and
alectinib, were approved in 2014 for advanced ALK-positive NSCLC in the US and
Japan, respectively. Heat shock protein 90 (Hsp90) inhibitors also showed
activity against ALK-positive NSCLC. Here we review the recent development of
crizotinib, ceritinib, alectinib and other second-generation ALK inhibitors as
well as Hsp90 inhibitors. We also discuss management strategies for advanced
ALK-positive NSCLC.