1. Novel targeted therapies for resistant ALK-rearranged non-small-cell lung cancer: ceritinib and beyond
- Author
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Cesar A. Perez, Ajit Paintal, Goetz H. Kloecker, and Zeyad Kanaan
- Subjects
medicine.drug_class ,Population ,Disease ,Review ,EML4-ALK rearrangement ,Bioinformatics ,ALK inhibitor ,Vysis ,medicine ,Pharmacology (medical) ,Epidermal growth factor receptor ,Lung cancer ,education ,education.field_of_study ,crizotinib ,Ceritinib ,biology ,Crizotinib ,business.industry ,Cancer ,medicine.disease ,Oncology ,Cancer research ,biology.protein ,business ,medicine.drug - Abstract
Lung cancer is the leading cause of cancer-related mortality in both sexes, accounting for over one quarter of cancer deaths. Non-small-cell lung cancer (NSCLC) comprises 85%–90% of lung cancer diagnoses and despite advances in multimodality therapies, 5-year survival rates remain dismal with a median survival for patients with metastatic disease of 1 year. The positive outcomes of targeted therapies against the kinase domain of epidermal growth factor receptor in NSCLC triggered consistent efforts to identify the so-called driver mutations as other potential targets. Anaplastic large-cell kinase (ALK) gene rearrangements were identified and targeted resulting in promising response rates in early studies. Unfortunately, most of the patients treated with crizotinib, the first-generation ALK inhibitor, progressed within 9 months. Ceritinib is a second-generation ALK inhibitor that has demonstrated activity in crizotinib-resistant patients, becoming a promising treatment option in this population. Furthermore, additional novel ALK inhibitors and agents targeting alternative pathways have been recruited to rechallenge this evasive disease post-crizotinib resistance.
- Published
- 2015