Alectinib in the treatment of ALK-positive metastatic non-small cell lung cancer: clinical trial evidence and experience with a focus on brain metastases

Autor: Pascale Tomasini, Julie Egea, M. Souquet-Bressand, Fabrice Barlesi, Laurent Greillier
Přispěvatelé: Service d'oncologie multidisciplinaire innovations thérapeutiques [Hôpital Nord - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Assistance Publique - Hôpitaux de Marseille (APHM), Centre de Recherche en Cancérologie de Marseille (CRCM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2019
Předmět:
Alectinib
Lung Neoplasms
[SDV]Life Sciences [q-bio]
Review
0302 clinical medicine
Piperidines
hemic and lymphatic diseases
Carcinoma
Non-Small-Cell Lung

brain metastases
Anaplastic lymphoma kinase
MESH: Protein Kinase Inhibitors
Pharmacology (medical)
Anaplastic Lymphoma Kinase
MESH: Anaplastic Lymphoma Kinase
Gene Rearrangement
0303 health sciences
Brain Neoplasms
MESH: Drug Resistance
Neoplasm

3. Good health
MESH: Piperidines
030220 oncology & carcinogenesis
MESH: Brain Neoplasms
Treatment strategy
Non small cell
Pulmonary and Respiratory Medicine
MESH: Mutation
MESH: Gene Rearrangement
Carbazoles
[SDV.BC]Life Sciences [q-bio]/Cellular Biology
03 medical and health sciences
medicine
Humans
alectinib
Lung cancer
Protein Kinase Inhibitors
non-small cell lung cancer
030304 developmental biology
lcsh:RC705-779
MESH: Humans
business.industry
ALK-Positive
lcsh:Diseases of the respiratory system
medicine.disease
MESH: Lung Neoplasms
Clinical trial
ALK
Drug Resistance
Neoplasm

Mutation
Cancer research
business
MESH: Carbazoles
MESH: Carcinoma
Non-Small-Cell Lung
Zdroj: Therapeutic Advances in Respiratory Disease
Therapeutic Advances in Respiratory Disease, SAGE Publishing, 2019, 13, pp.175346661983190. ⟨10.1177/1753466619831906⟩
Therapeutic Advances in Respiratory Disease, Vol 13 (2019)
Therapeutic Advances in Respiratory Disease, 2019, 13, pp.175346661983190. ⟨10.1177/1753466619831906⟩
ISSN: 1753-4666
1753-4658
DOI: 10.1177/1753466619831906⟩
Popis: International audience; Molecular profiling of metastatic nonsquamous non-small cell lung cancer (NSCLC) is required to guide the treatment strategy. Anaplastic lymphoma kinase ( ALK) gene rearrangements are found in approximately 5% of lung adenocarcinomas and are associated with specific clinical features including a high risk of brain metastases. Crizotinib was the first ALK inhibitor developed and it demonstrated improved outcomes in patients with ALK-positive advanced NSCLC in comparison with chemotherapy. However, despite an initial response, all ALK-positive NSCLC patients develop acquired resistance to crizotinib. Because the most frequent mechanism of resistance is the development of a secondary ALK mutation, second (ceritinib, alectinib, brigatinib) and third-generation (lorlatinib) ALK inhibitors were developed. Alectinib is a second-generation ALK inhibitor and was shown to be effective for a broad spectrum of ALK rearrangements and ALK mutations. It was also shown to have high intracranial efficacy. In this article, we review clinical trial evidence of alectinib efficacy as well as publications reporting the experience of alectinib in daily practice, with a focus on brain metastases.
Databáze: OpenAIRE