How do you think about sequencing therapy for a patient with ALK+ metastatic NSCLC given the available options?
What is the current data regarding acquired resistance mutations for ALK?
Should third generation TKIs such as lorlatinib be reserved for later lines as a means of overcoming resistance, or started in front-line?
Answer from: Medical Oncologist at Academic Institution
The types and incidence of resistance mutations vary based on the 2nd generation ALK inhibitor given, and is most commonly the G1202R mutation, which unfortunately denotes resistance to alectinib where it accounts for about 29% of acquired resistance and brigatinib where it accounts for about 43% of...
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Medical Oncologist at NYU Winthrop Hospital Great review!
Answer from: Medical Oncologist at Academic Institution
Updated answer - March 4, 2025 Given the 5-year CROWN trial update, there has been renewed interest in how to incorporate such findings into clinical practice.In patients at high risk for early disease progression such as certain ALK variants (3a/b and 5a/b compared to the more favorable v...
Answer from: Medical Oncologist at Academic Institution
We have come a long way since the development and approval of crizotinib for ALK rearranged lung cancer. More recently, second generation ALK directed therapy including alectinib, brigatinib as well as ceritinib and ensartinib have been clinically tested and have shown improvement in outcome. More r...
Great review!