Back to Search
Start Over
Stratégies thérapeutiques dans le cancer bronchique non à petites cellules ALK positif de stade IV
- Source :
- Revue des Maladies Respiratoires. 36:1107-1116
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Anaplastic lymphoma kinase (ALK) rearrangement is a therapeutically targetable oncogenic driver found in 5% of patients with non-small-cell lung cancer (NSCLC). The objective of this paper is to synthesise current knowledge on ALK rearrangement and its impact on the management of advanced NSCLC. Several inhibitors of the tyrosine kinase of ALK (crizotinib, ceritinib, alectinib) have been approved as first line therapies in patients with advanced ALK positive NSCLC, which are associated with a better median progression-free survival than conventional chemotherapy. Unfortunately, the emergence of drug resistance leads to tumor progression. In patients with oligoprogressive disease if local ablative therapy can be effected, continuing with the same ALK tyrosine kinase inhibitor is one option. In patients with progression, clinicians may consider switching to another therapy. Rebiopsy of the tumor or liquid biopsy could be attempted to identify the mechanisms of resistance and to customize ALK-target therapy. The emergence of crizotinib drug resistance has prompted the development of next generation drugs including ceritinb, alectinib, brigatinib and lorlatinib. The ability to quickly develop targeted therapies against specific oncogenic drivers will require close co-operation between pathologists, pulmonologists and oncologists in the future to keep pace with drug discoveries and to define optimal therapeutic strategies.
- Subjects :
- Pulmonary and Respiratory Medicine
Oncology
Alectinib
medicine.medical_specialty
Brigatinib
Crizotinib
Ceritinib
business.industry
medicine.disease
Lorlatinib
03 medical and health sciences
0302 clinical medicine
030228 respiratory system
Tumor progression
hemic and lymphatic diseases
Internal medicine
medicine
Anaplastic lymphoma kinase
030212 general & internal medicine
business
Lung cancer
medicine.drug
Subjects
Details
- ISSN :
- 07618425
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Revue des Maladies Respiratoires
- Accession number :
- edsair.doi...........19f4bb81e39dafc650cc24f63433d691