6533b7d4fe1ef96bd126292a
RESEARCH PRODUCT
Central nervous system involvement in ALK-rearranged NSCLC : promising strategies to overcome crizotinib resistance
Giuseppina Rosaria Rita RicciardiGiuseppe BronteChristian RolfoAlessandro RussoTindara FranchinaAntonio RussoVincenzo AdamoGiuseppa FerraroA. Scimonesubject
0301 basic medicineLung NeoplasmsSettore MED/06 - Oncologia MedicaPyridinesPyridineDrug ResistanceNSCLCTyrosine-kinase inhibitorALK translocations Brain metastases central nervous system metastases leptomeningeal metastases NSCLC Animals Antineoplastic Agents Brain Neoplasms Carcinoma Non-Small-Cell Lung Drug Design Drug Resistance Neoplasm Gene Rearrangement Humans Lung Neoplasms Protein Kinase Inhibitors Pyrazoles Pyridines Receptor Protein-Tyrosine Kinases Oncology Pharmacology (medical)Cns penetrationAntineoplastic Agent0302 clinical medicinecentral nervous system metastasesCarcinoma Non-Small-Cell Lunghemic and lymphatic diseasesMedicinePharmacology (medical)Anaplastic Lymphoma Kinaseleptomeningeal metastaseNon-Small-Cell LungGene RearrangementBrain NeoplasmsReceptor Protein-Tyrosine Kinasemedicine.anatomical_structureOncology030220 oncology & carcinogenesisNon small cellHumanmedicine.drugBrain metastasemedicine.drug_classCentral nervous systemProtein Kinase InhibitorCNS InvolvementAntineoplastic AgentsALK translocationBrain Neoplasm03 medical and health sciencesCrizotinibAnimalsHumansCns activityCrizotinib resistanceProtein Kinase Inhibitorsleptomeningeal metastasescentral nervous system metastaseCrizotinibAnimalbusiness.industryCarcinomaReceptor Protein-Tyrosine KinasesBrain metastasesLung Neoplasm030104 developmental biologyALK translocationsDrug Resistance NeoplasmDrug DesignPyrazoleImmunologyCancer researchNeoplasmPyrazolesHuman medicinebusinessdescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-01-01 | Expert review of anticancer therapy |