The Emerging Therapeutic Landscape of ALK Inhibitors in Non-Small Cell Lung Cancer

The Emerging Therapeutic Landscape of ALK Inhibitors in Non-Small Cell Lung Cancer
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DOI:
10.3390/ph13120474
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发表时间:
2020-12-18
期刊:
影响因子:
4.6
通讯作者:
Bazan V
Bazan V
中科院分区:
医学3区
文献类型:
--
作者:
Gristina V;La Mantia M;Iacono F;Galvano A;Russo A;Bazan V

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过去十年,转移性非小细胞肺癌(NSCLC)的治疗经历了范式转变。该疾病更好的分子特征导致了个性化医疗的快速改进,并为非小细胞肺癌患者及时提供靶向治疗。 2011 年,在少数受 NSCLC 影响的患者中发现了 EML4-ALK 融合基因,并随后进行了克唑替尼的临床开发,这是肺癌研究中令人印象深刻的里程碑。不幸的是,获得性耐药性经常出现,从而导致疾病进展。此后,现代酪氨酸激酶抑制剂(TKI),如色瑞替尼、艾来替尼、布加替尼和劳拉替尼,已被美国食品和药物管理局(FDA)批准用于治疗间变性淋巴瘤激酶(ALK)阳性的非小细胞肺癌。目前正在研究几种化合物以实现最佳治疗策略。此外,正在进行的新一代 TKI 临床试验的结果将为 ALK 阳性 NSCLC 患者的最佳治疗顺序提供更多证据。在这篇综述中,我们全面概述了 ALK 阳性 NSCLC 的最先进的靶向治疗方案。对耐药性、克服耐药性的潜在治疗策略以及这部分患者的未来前景进行了批判性分析和总结。
The treatment of metastatic non-small cell lung cancer (NSCLC) has undergone a paradigm shift over the last decade. Better molecular characterization of the disease has led to the rapid improvement of personalized medicine and the prompt delivery of targeted therapies to patients with NSCLC. The discovery of the EML4-ALK fusion gene in a limited subset of patients affected by NSCLC and the subsequent clinical development of crizotinib in 2011 has been an impressive milestone in lung cancer research. Unfortunately, acquired resistances regularly develop, hence disease progression occurs. Afterward, modern tyrosine kinase inhibitors (TKIs), such as ceritinib, alectinib, brigatinib, and lorlatinib, have been approved by the Food and Drug Administration (FDA) for the management of anaplastic lymphoma kinase (ALK)-positive NSCLCs. Several compounds are currently under investigation to achieve the optimal strategy of therapy. Additionally, the results of ongoing clinical trials with novel-generation TKI will provide more evidence on the best sequence in the treatment of ALK-positive NSCLC patients. In this review, we provide a comprehensive overview of the state-of-the-art targeted therapy options in ALK-positive NSCLCs. Resistance, potential therapeutic strategies to overcome drug resistance, and future perspectives for this subset of patients are critically analyzed and summarized.
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