Abstract
In anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer, brain metastases occur in 22–33% of cases at diagnosis and could reach up to 70% after crizotinib failure. Next-generation ALK inhibitors (ngALKi) have superior intracranial activity and prolonged responses compared with crizotinib and chemotherapy, as was shown in treatment-naïve or crizotinib pre-treated patients, irrespective of prior brain irradiation. Nevertheless, central nervous system relapse is also seen with ngALKi. Tailored treatment is necessary to obtain long-term survival without detrimental effects on cognition. Possible options include profiling secondary mutations to select sequential ngALKi, stereotactic radiotherapy and/or surgery, with the aim to avoid/deter whole brain irradiation.
Original language | English |
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Pages (from-to) | 18-21 |
Number of pages | 4 |
Journal | European Oncology and Haematology |
Volume | 16 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jan 2020 |
Keywords
- Anaplastic lymphoma kinase
- Brain metastases
- Non-small cell-lung cancer
- Personalised treatment