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What is the treatment for stage IV lung cancer with ALK rearrangement?

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Medicines called ALK inhibitors are the main kind of treatment. These drugs block the abnormal ALK protein and shrink lung tumors linked to it. Your doctor might call this “targeted therapy” because it zooms in on the cancer cells and disrupts their growth. You should only take these drugs if a FISH test shows you have the mutation.  

These drugs won't cure you, but they should improve quality of life. Crizotinib (Xalkori) is usually the first ALK inhibitor prescribed. It's a pill you take twice a day. After a few years, the medicine may stop working. This is called resistance. If this happens, or if the cancer spreads, you may need to switch to another ALK inhibitor.

Your doctor will consider alectinib (Alecensa), brigatinib (Alunbrig), ceritinib (Zykadia), crizotinib (Xalkori), and lorlatinib (Lorbrena). These are also pills you take once or twice a day.

SOURCES:

Roswell Park Cancer Institute: "Targeting Anaplastic Lymphoma Kinase (ALK) Gene in Non-Small Cell Lung Cancer."

My Cancer Genome: "ALK in Non-Small Cell Lung Cancer (NSCLC)."

Genetics Home Reference: "ALK."

Lung Cancer Foundation of America: "What Targeted Therapies Are Currently Available?"

Memorial Sloan Kettering Cancer Center: "Genomic Testing."

UpToDate: Anaplastic lymphoma kinase (ALK) fusion oncogene positive non-small cell lung cancer.”

American Cancer Society: "Treatment choices by stage for non-small cell lung cancer."

American Cancer Society: "Targeted therapies for non-small cell lung cancer."

Bang, Y.J. October 2012. Archives of Pathology & Laboratory Medicine,

Korpanty, G.J. , 2014. Frontiers in Oncology

UpToDate: “Patient information: Non-small cell lung cancer treatment; stage IV cancer (Beyond the Basics)."

Lab Tests Online. "ALK Mutation (Gene Rearrangement)." 

American Cancer Society: “Cancer Facts & Figures 2015.”

American Cancer Society: “Lung Cancer (Non-Small Cell).”

Reviewed by Paul Boyce on February 19, 2019

SOURCES:

Roswell Park Cancer Institute: "Targeting Anaplastic Lymphoma Kinase (ALK) Gene in Non-Small Cell Lung Cancer."

My Cancer Genome: "ALK in Non-Small Cell Lung Cancer (NSCLC)."

Genetics Home Reference: "ALK."

Lung Cancer Foundation of America: "What Targeted Therapies Are Currently Available?"

Memorial Sloan Kettering Cancer Center: "Genomic Testing."

UpToDate: Anaplastic lymphoma kinase (ALK) fusion oncogene positive non-small cell lung cancer.”

American Cancer Society: "Treatment choices by stage for non-small cell lung cancer."

American Cancer Society: "Targeted therapies for non-small cell lung cancer."

Bang, Y.J. October 2012. Archives of Pathology & Laboratory Medicine,

Korpanty, G.J. , 2014. Frontiers in Oncology

UpToDate: “Patient information: Non-small cell lung cancer treatment; stage IV cancer (Beyond the Basics)."

Lab Tests Online. "ALK Mutation (Gene Rearrangement)." 

American Cancer Society: “Cancer Facts & Figures 2015.”

American Cancer Society: “Lung Cancer (Non-Small Cell).”

Reviewed by Paul Boyce on February 19, 2019

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What are the side effects of treatment for stage IV lung cancer with ALK rearrangement?

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