2022 World Conference on Lung Cancer (ePosters)-EP08.02-009. Progression Pattern, Resistance Mechanism and Subsequent Therapy for ALK Positive NSCLC in the Era of Second-Generation ALK-TKIs

EP08.02-009. Progression Pattern, Resistance Mechanism and Subsequent Therapy for ALK Positive NSCLC in the Era of Second-Generation ALK-TKIs

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This study aimed to evaluate the progression pattern, resistance mechanism, and subsequent therapy in patients with ALK positive NSCLC in the era of second-generation ALK-TKIs. The study included two cohorts: Cohort 1 consisted of patients who experienced progression after treatment with alectinib, and Cohort 2 consisted of patients who progressed after sequential therapy of crizotinib followed by second-generation ALK-TKIs.<br /><br />The results showed that CNS progression was more common in patients treated with crizotinib compared to alectinib. Alectinib showed potent CNS protective effects. The study also identified various resistance mechanisms, with the dominant mechanism being resistance mutation in the ALK kinase domain, especially G1202R. Oligo-progression cases were treated with local ablative therapy in more than half of the cases.<br /><br />Furthermore, the study emphasized the importance of rebiopsy to establish clinical regimens and estimate the effectiveness of subsequent treatments. It was highlighted that patients should not overlook the option of chemotherapy, as it is still an important strategy, particularly for patients who are insensitive to targeted therapy.<br /><br />The study concluded that alectinib has effective CNS protective effects, and rebiopsy should be given significant attention in the era of second-generation ALK-TKIs. Additionally, chemotherapy should not be disregarded as an important treatment option for patients without ALK secondary mutation.<br /><br />In summary, this study provides valuable insights into the progression pattern, resistance mechanisms, and subsequent therapy for ALK positive NSCLC in the era of second-generation ALK-TKIs. It highlights the importance of personalized treatment approaches and the need for further research in this field.

Asset Subtitle

Zihua Zou

Meta Tag

Speaker Zihua Zou

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

progression pattern

resistance mechanism

therapy

ALK positive NSCLC

second-generation ALK-TKIs

CNS progression

ALK kinase domain

oligo-progression

rebiopsy

chemotherapy