Adverse Event Management in Anaplastic Lymphoma Kinase-positive Non-small Cell Lung Cancer
Abstract
Overview
The development of oncogene-directed targeted therapies represents a new paradigm in the treatment of non-small cell lung cancer (NSCLC), offering improved outcomes compared with chemotherapy. Rearrangements of the anaplastic lymphoma kinase (ALK) gene are major oncogenic drivers in a subset of NSCLC patients. Since its launch in 2011, the ALK inhibitor crizotinib has become the standard of care in ALK-positive NSCLC, but resistance inevitably develops. Ceritinib and alectinib have received regulatory approval: the former in Europe, US and elsewhere in the world, the latter in Japan. ALK inhibitors target multiple pathways, and may therefore be associated with a wide range of adverse events (AEs), including gastrointestinal AEs, hepatotoxicity and, in the case of crizotinib and ceritinib, cardiac effects. While the majority of these AEs are reversible, manageable and not severe, it is important that both physician and patients are aware of toxicities to ensure prompt treatment. This article discusses the management of AEs in patients receiving currently approved ALK inhibitors, including treatment, regular monitoring, drug discontinuation or dose reduction and physician/patient education. Proactive management of AEs enhances patient quality of life and optimises the therapeutic index of these agents.
Keywords
Alectinib, ceritinib, crizotinib, ALK-positive non-small cell lung cancer
Article Information
Disclosure
Christian Rolfo has served on the Novartis International Speakers Bureau. Solange Peters and Ignacio Gil-Bazo have no conflicts of interest to declare.
Correspondence
Christian Rolfo, Associate Professor, University Hospital Antwerp Oncology, Head of Phase I Early Clinical Trials Unit, Antwerp, Belgium. E: Christian.Rolfo@uza.be
Support
The publication of this article was supported by Novartis, who were given the opportunity to review the article for scientific accuracy before submission. Any resulting changes were made at the author’s discretion.
Access
This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit.
Acknowledgements
Medial writing assistance was provided by Katrina Mountfort at Touch Medical Media and funded by Novartis.
Received
2015-05-12T00:00:00
Further Resources
Trending Topic
This issue of touchREVIEWS in Oncology & Haematology brings together a diverse collection of articles reflecting the growing complexity of cancer care and the continued evolution of precision medicine across tumour types. From rare malignancies and treatment-related challenges to emerging targeted therapies and novel biological insights, the contributions highlight both recent progress and the significant […]
This issue of touchREVIEWS in Oncology & Haematology brings together a diverse collection of articles reflecting the growing complexity of cancer care and the continued evolution of precision medicine across tumour types. From rare malignancies and treatment-related challenges to emerging ...
Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality worldwide.1Â Over the past two decades, the molecular characterization of NSCLC has transformed the therapeutic landscape by enabling the development of targeted therapies that have significantly improved outcomes ...
It is with great pleasure that we present the latest edition of touchREVIEWS in Oncology & Haematology. This edition showcases the continued advances and innovation reshaping cancer care, as well as highlighting the continued unmet needs and challenges associated with ...
Early-onset lung cancer is typically defined as occurring in individuals aged 18–50 years, although there is no universally accepted definition.1–3 This entity, though rare, poses unique diagnostic and therapeutic challenges. This article synthesizes current evidence on the unique features and management ...
We are delighted to present the latest edition of touchREVIEWS in Oncology & Haematology. This issue underscores the evolving landscape of cancer therapeutics, showcasing advances across a wide range of malignancies, from haematologic diseases to solid tumours, through novel mechanisms, ...
Lung cancer is the second most common type of cancer worldwide and in the USA, with its incidence varying depending on geographic and socioeconomic factors.1–3 According to data from the Global Cancer Observatory: Cancer Incidence, Mortality and Prevalence (GLOBACAN) database, ...
It is with great pleasure that we present the latest edition of touchREVIEWS in Oncology & Haematology. This issue highlights the remarkable progress and innovation shaping the fields of oncology and haematology, featuring articles that delve into both emerging therapies ...
Highlights Immunotherapy, especially combinatory immunotherapy, has shown promise with prolonged survival for patients with advanced mesothelioma in the first-line setting (see the sections on ‘Systemic treatment and immunotherapy debut’ and ‘Randomized immunotherapy trials of mesothelioma’). Histology-based therapy is important to ...
Welcome to the latest issue of touchREVIEWS in Oncology & Haematology. We are honoured to present a series of compelling articles that reflect cutting-edge developments and diverse perspectives in this ever-evolving field. This issue includes a series of editorials and ...
Unmet clinical needs for patients with advanced epidermal growth factor receptor-mutated non–small-cell lung cancer Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) have become the standard first-line therapy for patients with advanced non–small-cell lung cancer (NSCLC) harbouring ...
Accurately detecting lung tumours and their margins is important for disease outcomes.1,2 However, detection is challenging due to the use of minimally invasive surgery and current localization techniques, such as computed tomography (CT)-guided and endobronchial interventions, which add significantly ...
Cancer treatment has expanded rapidly in recent years as advancements in the fields of tumour biology and molecular diagnostics have informed the development of targeted therapies, improving survival in patients with oncogene-addicted cancers with therapeutically relevant molecular lesions. Osimertinib has ...
Log into your Touch Account
Keep track of your clinical interests and newsletter subscriptions.
Sign up with an Email
Or use a .
Register now for FREE access
Already registered? Login below.
