Melosky B, Agulnik J, Albadine R, Banerji S, Bebb D G, Bethune D, Blais N, Butts C, Cheema P, Cheung P, Cohen V, Deschenes J, Ionescu D N, Juergens R, Kamel-Reid S, Laurie S A, Liu G, Morzycki W, Tsao M S, Xu Z, Hirsh V
British Columbia: BC Cancer Agency, Vancouver Centre, Vancouver, BC (Melosky, Ionescu);
Quebec: Jewish General Hospital, McGill University, Montreal, QC (Agulnik); chum -Hôpital St-Luc, Montreal, QC (Albadine); chum -Hôpital Notre-Dame, Montreal, QC (Blais); Royal Victoria Hospital, Montreal, QC (Hirsh); Segal Cancer Centre and Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC (Cohen);
Curr Oncol. 2016 Jun;23(3):196-200. doi: 10.3747/co.23.3120. Epub 2016 Jun 9.
Anaplastic lymphoma kinase (alk) is an oncogenic driver in non-small-cell lung cancer (nsclc). Chromosomal rearrangements involving the ALK gene occur in up to 4% of nonsquamous nsclc patients and lead to constitutive activation of the alk signalling pathway. ALK-positive nsclc is found in relatively young patients, with a median age of 50 years. Patients frequently have brain metastasis. Targeted inhibition of the alk pathway prolongs progression-free survival in patients with ALK-positive advanced nsclc. The results of several recent clinical trials confirm the efficacy and safety benefit of crizotinib and ceritinib in this population. Canadian oncologists support the following consensus statement: All patients with advanced nonsquamous nsclc (excluding pure neuroendocrine carcinoma) should be tested for the presence of an ALK rearrangement. If an ALK rearrangement is present, treatment with a targeted alk inhibitor in the first-line setting is recommended. As patients become resistant to first-generation alk inhibitors, other treatments, including second-generation alk inhibitors can be considered.
间变性淋巴瘤激酶（ALK）是非小细胞肺癌（NSCLC）中的致癌驱动因子。涉及ALK基因的染色体重排在高达4%的非鳞状NSCLC患者中出现，并导致ALK信号通路的组成性激活。ALK阳性的NSCLC多见于相对年轻的患者，中位年龄为50岁。患者常发生脑转移。靶向抑制ALK通路可延长ALK阳性晚期NSCLC患者的无进展生存期。最近几项临床试验的结果证实了克唑替尼和色瑞替尼在该人群中的疗效和安全性益处。加拿大肿瘤学家支持以下共识声明：所有晚期非鳞状NSCLC（不包括纯神经内分泌癌）患者均应检测是否存在ALK重排。如果存在ALK重排，建议在一线治疗中使用靶向ALK抑制剂。当患者对第一代ALK抑制剂产生耐药性时，可以考虑其他治疗方法，包括第二代ALK抑制剂。
