Anaplastic lymphoma kinase inhibitors in elderly patients with advanced non-small cell lung cancer.
BACKGROUND
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related deaths in the USA and worldwide. At diagnosis, half of the patients are over 70 years of age, and most present with advanced disease for which chemotherapy provides modest benefit with significant toxicity. Older patients often have more comorbidities than their younger counterparts and tend to be excluded from clinical trials.


METHODS
A small percentage (less than 7%) of patients with NSCLC have the anaplastic lymphoma kinase (ALK) rearrangement. Compared to the general NSCLC population, this clinically distinct group has a relatively younger median age of 51 years at diagnosis. As such, elderly patients with ALK-positive disease are both a minority within this group and are expected to be underrepresented in clinical trials. Expert commentary: Despite promising results in the general population, data about the efficacy and safety of ALK inhibitors in the elderly population remains scarce. In our review, we briefly discuss the current evidence of ALK inhibitors in the general population and we shed light on this subgroup of elderly patients with advanced ALK-positive disease.
a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA.
Mazen
M
Zaarour
a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA.
Bassel
B
Nazha
a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA.
Chanudi
C
Weerasinghe
a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA.
Elias
E
Moussaly
b Department of Medicine, Division of Hematology/Oncology , Staten Island University Hospital Northwell Health , Staten Island , NY , USA.
Terenig
T
Terjanian
D000367:Age Factors; D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics; D015321:Gene Rearrangement; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000494:pharmacology; D020794:Receptor Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors* / Q000235:genetics
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
ALK inhibitors; Non-small cell lung cancer; anaplastic lymphoma kinase; ceritinib; crizotinib; elderly