The discovery of predictive biomarkers, such as sensitizing epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) rearrangements, ROS1 rearrangements, and BRAF V600E mutations has led to an improvement in overall survival and progression-free survival in non–small cell lung cancer (NSCLC) by identifying subgroups of patients who benefit from targeted treatment. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines®) note, “For patients with recurrent and metastatic disease, the NCCN Guidelines recommend that histologic subtype should be determined before therapy so that the best treatment can be selected. In addition, biomarker testing for genetic alterations (ie, oncogenic driver events) is recommended in patients with NSCLC, because targeted therapy has been shown to decrease tumor burden, decrease symptoms, and dramatically improve the quality of life for patients with specific genetic alterations. The number of available targeted agents is increasing.” (Ettinger et al, 2020.)
Approximately 5% of patients with NSCLC have ALK gene rearrangements. One of the most noteworthy areas of progress is the development of effective ALK-targeting therapies to treat NSCLC, including crizotinib, ceritinib, alectinib, brigatinib, and lorlatinib. Because of the fast pace of developments in this area, it may be difficult for clinicians to remain up-to-date on the management of ALK+ metastatic NSCLC, making it challenging to provide state-of-the-art care to their patients.
This activity will review molecular testing for ALK rearrangements, approved and emerging therapeutic options for the first-line treatment of ALK+ NSCLC and treatment upon disease progression, treatment selection and sequencing, and efficacy and safety data of ALK inhibitors.