Review of Therapeutic Strategies for Anaplastic Lymphoma Kinase-Rearranged Non-Small Cell Lung Cancer.
Takafumi FukuiMotoko TachiharaTatsuya NaganoKazuyuki KobayashiPublished in: Cancers (2022)
Non-small cell lung cancer (NSCLC) with anaplastic lymphoma kinase rearrangement (ALK) was first reported in 2007. ALK-rearranged NSCLC accounts for about 3-8% of NSCLC. The first-line therapy for ALK-rearranged advanced NSCLC is tyrosine kinase inhibitors (TKI) targeting ALK. Following the development of crizotinib, the first ALK-TKI, patient prognosis has been greatly improved. Currently, five TKIs are approved by the FDA. In addition, clinical trials of the novel TKI, ensartinib, and fourth-generation ALK-TKI for compound ALK mutation are ongoing. Treatment with angiogenesis inhibitors and immune checkpoint inhibitors is also being studied. However, as the disease progresses, cancers tend to develop resistance mechanisms. In addition to ALK mutations, other mechanisms, including the activation of bypass signaling pathways and histological transformation, cause resistance, and the identification of these mechanisms is important in selecting subsequent therapy. Studies on tissue and liquid biopsy have been reported and are expected to be useful tools for identifying resistance mechanisms. The purpose of this manuscript is to provide information on the recent clinical trials of ALK-TKIs, angiogenesis inhibitors, immune checkpoint inhibitors, and chemotherapy to describe tissue and liquid biopsy as a method to investigate the mechanisms of resistance against ALK-TKIs and suggest a proposed treatment algorithm.
Keyphrases
- advanced non small cell lung cancer
- epidermal growth factor receptor
- clinical trial
- tyrosine kinase
- small cell lung cancer
- diffuse large b cell lymphoma
- randomized controlled trial
- signaling pathway
- stem cells
- deep learning
- mesenchymal stem cells
- healthcare
- radiation therapy
- cell proliferation
- drug delivery
- squamous cell carcinoma
- cancer therapy
- social media
- study protocol
- double blind
- health information
- wound healing
- endoplasmic reticulum stress
- bioinformatics analysis