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Diagnosis and Treatment of ALK Aberrations in Metastatic NSCLC

  • Alex Friedlaender
  • Giuseppe Banna
  • Sandip Patel
  • Alfredo AddeoEmail author
Lung Cancer (HA Wakelee, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lung Cancer

Opinion statement

There has been rapid progress in the use of targeted therapies for ALK-positive which has led to improve dramatically PFS and OS in the metastatic ALK-rearranged NSCLC patients. There are several molecules now available (crizotinib, ceritinib, brigatinib, alectinib, and lorlatinib) and others in development. Such an improvement in treatment efficacy has even more highlighted the importance of an adequate identification of ALK alterations. Efficient and easily accessible testing tools are required to identify eligible patients in a timely fashion. Different methods for detecting ALK+ NSCLC patients are now available, with fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) currently representing validated diagnostic techniques for the initial assessment of ALK status. Furthermore the widespread use of next-generation sequencing to detect other possible different activating mutations has allowed to identify individual ALK fusion variants. Several more expensive and time-consuming methods are also available nowadays which have the advantage to detect even rarer uncommon ALK fusion variants and mutations in tumour or blood samples. A review of the evolving testing-treatment landscape is needed to highlight the importance of properly diagnosing and treating this group of patients.

Keywords

NSCLC ALK aberration Testing 

Notes

Compliance with Ethical Standards

Conflict of Interest

Alex Friedlaender has received compensation from Roche, Pfizer, Astellas and BMS for advisory roles.

Giuseppe Banna declares that he has no conflict of interest.

Sandip Patel has received compensation from AstraZeneca, Bristol-Myers Squibb, Illumina, Nektar Therapeutics, and Tempus for service on advisory boards, and his university receives research funding from Bristol-Myers Squibb, Eli Lilly, Fate Therapeutics, Incyte, AstraZeneca/MedImmune, Merck, Pfizer, Roche/Genentech, Xcovery, Fate Therapeutics, Genocea, and Iovance Biotherapeutics.

Alfredo Addeo has received compensation from Takeda, MSD, BMJ, AstraZeneca, Roche, and Pfizer for service on advisory boards.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Alex Friedlaender
    • 1
  • Giuseppe Banna
    • 2
  • Sandip Patel
    • 3
  • Alfredo Addeo
    • 1
    Email author
  1. 1.Oncology DepartmentGeneva University Hospital (CH)GenèveSwitzerland
  2. 2.Division of Medical Oncology, Cannizzaro HospitalCataniaItaly
  3. 3.Sandip Pravin Patel, UC San Diego Moores Cancer CenterLa JollaUSA

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