Non‑small cell lung cancer with ALK and ROS1 genes rearregement

05/2018

Prof. MUDr. Miloš Pešek, CSc.

Klinika pneumologie a ftizeologie LF UK a FN Plzeň

SUMMARY

In a review author present the state - of the art of diagnostics and therapy of advanced non-small cell lung cancer with ALK and ROS1 genes rearrangements. Diagnostic processes are realized in specialized pathologic departments with the help of histology, imunohistochemistry and fluorescent in situ hybridization. Patients suffering by either with ALK positive NSCLC, or ROS1 positive non-small cell lung cancer reach significant benefits from targeted therapy with ALK and ROS1 tyrosinkinase inhibitors. In ALK positive advanced non-small cell lung cancer international guidelines recommend to treat with crizotinib, ceritinib or alectinib, while in cases of failure of this therapy, brigatinib should be the second line biologic treatment. In ROS1 positive advanced NSCLC, crizotinib or ceritinib are recommended accordingly to international guidelines. However, in the Czech Republic, there is no approval of those drugs in first line setting.

KEY WORDS

non-small cell lung cancer, immunohistochemistry, ALK gene rearrangement, ROS1 gene rearrangement, targeted therapy, crizotinib, ceritinib, alectinib, brigatinib