Central nervous system involvement in ALK-rearranged NSCLC: promising strategies to overcome crizotinib resistance

Giuseppe Bronte, Antonio Russo, Tindara Franchina, Giuseppa Ferraro, Giuseppina Rosaria Rita Ricciardi, Alessandro Russo, Christian Rolfo, Antonino Scimone, Vincenzo Adamo, Christian Diego Rolfo, Giuseppa Ferraro

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

ABSTRACT: Introduction: ALK rearranged Non Small Cell Lung Cancers (NSCLCs) represent a distinct subgroup of patients with peculiar clinic-pathological features. These patients exhibit dramatic responses when treated with the ALK tyrosine kinase inhibitor Crizotinib, albeit Central Nervous System (CNS) activity is much less impressive than that observed against extracranial lesions. CNS involvement has become increasingly observed in these patients, given their prolonged survival. Several novel generation ALK inhibitors have been developing to increase CNS penetration and to provide more complete ALK inhibition. Areas covered: The CNS activity of Crizotinib and novel generation ALK inhibitors will be summarized in this review, evaluating the strengths and weaknesses of the therapeutic strategies developed to date in this specific subgroup of NSCLCs with a look towards the future. Expert commentary: In the next few years, the results of ongoing comparative head-to-head trials will provide the definitive conclusions on the optimal treatment sequence in ALK-rearranged NSCLCs. Moreover, ongoing clinical trials with novel-generation ALK inhibitors will produce more evidences on the best approach in the growing number of ALK-positive NSCLCs with CNS involvement.
Original languageEnglish
Pages (from-to)615-623
Number of pages9
JournalExpert Review of Anticancer Therapy
Volume16
Publication statusPublished - 2016

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pharmacology (medical)

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