ALK positive lung cancer

From WikiMD's Food, Medicine & Wellness Encyclopedia

ALK positive lung adenocarcinoma -- low mag

ALK positive lung cancer is a subtype of non-small cell lung cancer (NSCLC) characterized by the presence of an abnormal gene fusion between the Anaplastic Lymphoma Kinase (ALK) gene and another gene, most commonly EML4 (Echinoderm Microtubule-associated protein-Like 4). This fusion leads to the expression of an oncogenic ALK fusion protein that drives the growth and proliferation of cancer cells. ALK positive lung cancer represents a distinct entity within NSCLC, with specific clinical features, diagnostic methods, and treatment options.

Epidemiology[edit | edit source]

ALK positive lung cancer accounts for approximately 3-7% of all NSCLC cases. It is more commonly diagnosed in younger patients, who often have a light or non-smoking history. The incidence is similar across different ethnic groups.

Pathophysiology[edit | edit source]

The ALK gene, located on chromosome 2p23, encodes a receptor tyrosine kinase involved in the development of the brain and exerts effects on specific neurons in the nervous system. The EML4-ALK fusion gene results from a chromosomal inversion, leading to the expression of a constitutively active ALK fusion protein. This protein activates several downstream signaling pathways, including PI3K/AKT, MEK/ERK, and JAK/STAT, promoting cell proliferation and survival.

Clinical Features[edit | edit source]

Patients with ALK positive lung cancer may present with symptoms similar to other types of lung cancer, including cough, dyspnea, weight loss, and chest pain. However, due to its association with younger, non-smoking patients, the diagnosis can sometimes be unexpected.

Diagnosis[edit | edit source]

The diagnosis of ALK positive lung cancer involves histological confirmation of NSCLC and subsequent molecular testing to identify the ALK rearrangement. Techniques used for detecting ALK rearrangements include fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and next-generation sequencing (NGS).

Treatment[edit | edit source]

The treatment landscape for ALK positive lung cancer has evolved significantly with the development of ALK inhibitors. Crizotinib was the first ALK inhibitor approved for the treatment of ALK positive NSCLC. Subsequent generations of ALK inhibitors, including ceritinib, alectinib, and brigatinib, have shown improved efficacy and are associated with a better side effect profile. Treatment with ALK inhibitors has demonstrated remarkable responses and significantly prolonged progression-free survival compared to chemotherapy. Resistance to ALK inhibitors is a clinical challenge, and management of resistance involves switching to different ALK inhibitors or combining with other therapeutic agents.

Prognosis[edit | edit source]

The prognosis for patients with ALK positive lung cancer has improved substantially with the advent of targeted therapy. However, the development of resistance to ALK inhibitors remains a significant hurdle. Ongoing research is focused on understanding mechanisms of resistance and developing new therapeutic strategies to overcome it.

Future Directions[edit | edit source]

Research in ALK positive lung cancer continues to evolve, with ongoing studies exploring the efficacy of combining ALK inhibitors with other treatments, such as chemotherapy, immunotherapy, or other targeted therapies. Additionally, efforts are underway to develop more potent ALK inhibitors and to identify biomarkers that can predict response to therapy.


Wiki.png

Navigation: Wellness - Encyclopedia - Health topics - Disease Index‏‎ - Drugs - World Directory - Gray's Anatomy - Keto diet - Recipes

Search WikiMD


Ad.Tired of being Overweight? Try W8MD's physician weight loss program.
Semaglutide (Ozempic / Wegovy and Tirzepatide (Mounjaro / Zepbound) available.
Advertise on WikiMD

WikiMD is not a substitute for professional medical advice. See full disclaimer.

Credits:Most images are courtesy of Wikimedia commons, and templates Wikipedia, licensed under CC BY SA or similar.

Contributors: Prab R. Tumpati, MD