Lorlatinib Should Be Considered as the Preferred First-Line Option in Patients With Advanced ALK-Rearranged NSCLC

Since the discovery of ALK-positive (ALK+) fusion in NSCLC in 2007, 1 ,2 we now know patients with ALK+ NSCLC can live up to 9 years after stage 4 diagnosis 3 , 4 , 5 but are constantly overshadowed by an unrelenting cumulative incidence of brain metastasis with time (>60% by year 6). 6 At the molecular level, the two most common EML4-ALK fusion variants, variant 1 (v1) and variant 3 (v3), have differential responses to ALK tyrosine kinase inhibitors (TKIs) 7 ,8 with the recalcitrant solvent-front ALK G1202R mutation arising more often from the background of EML4-ALK variant 3. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2020.12.021

Authors: Misako Nagasaka, Sai-Hong Ignatius Ou