title: The role of alectinib in the treatment of advanced ALK-rearranged non-small-cell lung cancer.
abstract: The identification of anaplastic lymphoma kinase (ALK) gene rearrangements in subsets of non-small cell lung cancer patients has provided with unparalleled opportunities to hinder the progression of this disease through targeting the activity of these specific molecules. Unfortunately most patients develop disease progression in less than a year of treatment with crizotinib, the first-generation ALK-inhibitor. Areas covered: We review the resistance mechanisms to ALK inhibitors as well as an overview of the clinical activity of the alectinib, a second generation ALK inhibitor. Expert commentary: Second generation ALK inhibitors as alectinib and ceritinib can overcome crizotinib-resistant mutations and improve central nervous system control. Novel third-generation inhibitors and combination of agents give hope of achieving an even longer disease control in the next decade.
authors.affiliation: a Division of Medical Oncology and Hematology, James Graham Brown Cancer Center , University of Louisville , Louisville , KY , USA.
authors.forename: Srividya
authors.initials: S
authors.lastname: Srinivasamaharaj
authors.affiliation: a Division of Medical Oncology and Hematology, James Graham Brown Cancer Center , University of Louisville , Louisville , KY , USA.
authors.forename: Bilal Khameze
authors.initials: BK
authors.lastname: Salame
authors.affiliation: a Division of Medical Oncology and Hematology, James Graham Brown Cancer Center , University of Louisville , Louisville , KY , USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rios-Perez
authors.affiliation: a Division of Medical Oncology and Hematology, James Graham Brown Cancer Center , University of Louisville , Louisville , KY , USA.
authors.forename: Goetz
authors.initials: G
authors.lastname: Kloecker
authors.affiliation: a Division of Medical Oncology and Hematology, James Graham Brown Cancer Center , University of Louisville , Louisville , KY , USA.
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Perez
mesh_terms: D000077548:Anaplastic Lymphoma Kinase; D000818:Animals; D002227:Carbazoles / Q000494:pharmacology / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D015321:Gene Rearrangement; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D010880:Piperidines / Q000494:pharmacology / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D020794:Receptor Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000235:genetics
chemical_list: D002227:Carbazoles; D010880:Piperidines; D047428:Protein Kinase Inhibitors; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases; C582670:alectinib
keywords: ALK gene rearrangement; Non-small cell lung cancer; alectinib; ceritinib