What are first-line therapy options for patients with non–small cell lung cancer (NSCLC) adenocarcinoma and anaplastic lymphoma kinase (ALK) rearrangements?

Updated: Jul 15, 2021
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

NSCLC adenocarcinoma with ALK rearrangements more commonly occurs in light smokers or non-smokers. These patients do not benefit from treatment with EGFR-directed TKIs. Instead, first-line therapy is with one of the following:

  • Alectinib (Alecensa) 
  • Brigatinib (Alunbrig) 
  • Lorlatinib (Lobrena) 
  • Crizotinib (Xalkori) if the  ALK rearrangement is discovered during first-line systemic therapy (eg, pembrolizumab/chemotherapy)
  • Ceritinib (Zykadia)

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