Understanding ALK Mutations in Non-Small Cell Lung Cancer
ALK gene mutations can drive the growth of non-small cell lung cancer (NSCLC). ALK (anaplastic lymphoma kinase) is a protein involved with sending signals to normal cells and is believed to be involved with the development of the nervous system. Unfortunately, the ALK gene can develop mutations that drive abnormal growth in cells. We don’t know the cause of ALK mutations yet.
ALK+ cancer affects 1 out of 25 NSCLC patients, typically people who are under 55 years old and have never smoked. Your care team can determine if the ALK gene has mutated using biomarker testing of the tumor. One important type of ALK mutation in NSCLC is a rearrangement of the ALK gene, where the ALK gene is fused to another gene. This ALK rearrangement (also called an ALK fusion) drives NSCLC, but is also a potential target for new and improving drugs.
How is an ALK Positive mutation treated?
If you have ALK+ NSCLC, you’re typically prescribed a drug called an ALK-inhibitor. There are currently 5 ALK inhibitors drugs available for treating NSCLC:
- Alectinib (Alecensa)
- Brigatinib (Alunbrig)
- Ceritinib (Zykadia)
- Crizotinib (Xalkori)
- Lorlatinib (Lorbrena)
These drugs are pills that you take once or twice a day, as prescribed by your oncologist. Some of the newer ALK drugs (alectinib, brigatinib, and lorlatinib) may either work better than the earlier drugs or may cause fewer side effects.
Are there side effects to ALK+ treatment?
Like any drug treatment, side effects are possible and can range from mild to more severe. Common side effects of ALK inhibitors include: nausea, vomiting, diarrhea, constipation, fatigue, and changes to your vision.
More severe side effects include inflammation of your lungs or other organs, liver damage, nerve damage, and abnormal heart rhythms.
Talk to your care team immediately if you’re experiencing any side effects.
Are there other options if my ALK+ treatment stops working?
It’s possible that your cancer will change after one or two years, and that the ALK-inhibitor might stop working. If that’s the case, your care team might prescribe a different drug, increase your existing dose, add chemotherapy or radiation to your treatment plan, and/or recommend a clinical trial or re-biopsy you to see if any new changes to the tumor have occurred.
For more information on what to do if your lung cancer progresses on your current treatment, this blog goes over the different options you can explore.
If you would like to learn more about ALK+ NSCLC or ALK inhibitors, you can connect with an Outcomes4Me oncology nurse practitioner at no charge through the Outcomes4Me app, using the “Ask Outcomes4Me” button.
