Treatment After Crizotinib Resistance in ALK plus Non-Small-Cell Lung Cancer

Kazaz S. N., ÖZTOP İ.

UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI, vol.27, no.1, pp.60-68, 2017 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 27 Issue: 1
  • Publication Date: 2017
  • Doi Number: 10.4999/uhod.171786
  • Journal Name: UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.60-68
  • Keywords: Non-small-cell lung cancer, ALK, Crizotinib, Resistance, ACQUIRED-RESISTANCE, INHIBITOR ALECTINIB, ANTITUMOR-ACTIVITY, CONFER RESISTANCE, PROGRESSION-FREE, PHASE-I, MODELS, CHEMOTHERAPY, PF-06463922, MUTATIONS
  • Dokuz Eylül University Affiliated: Yes

Abstract

Systemic chemotherapy, genotype-based targeted therapies and immunotherapy are widely used in the treatment of advanced non small-cell lung cancer (NSCLC). Among the targeted therapies, the agents targeting the epidermal growth factor receptor (EGFR), the echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase (EML4-ALK) rearrangement and C-ros oncogene 1 (ROS-1) have currently become standard treatment for cases presenting such molecular anomalies. Of them, cases with ALK-rearrangement displayed dramatic results with a first generation ALK-inhibitor crizotinib; however, most of the patients develop a resistance in a few years. Especially the central nervous system relapses pose the most common clinical problem. Next generation ALK-inhibitors are promising with a high level of effectiveness in this resistance, in which various molecular mechanisms take part. Also, it gains increasing importance to re-perform a biopsy in the progression stage and reveal the mechanisms causing the secondary resistance in those patients.