ALK-positive non-small cell lung cancer (NSCLC) is a subtype of lung cancer characterized by the presence of an abnormal ALK gene fusion. Targeted therapies have been developed to specifically inhibit the activity of the ALK protein, which can help to control tumor growth and progression.
The use of tyrosine kinase inhibitors (TKIs) has led to significantly improved survival benefits for patients with ALK-positive non-small cell lung cancer (NSCLC). However, the clinical benefits of targeting ALK using TKIs are limited due to the emergence of drug resistance.
The drugs that have been approved by the U.S. Food and Drug Administration (FDA) to target ALK-positive lung cancer are called ALK inhibitors and include:
Crizotinib (Xalkori) is the targeted therapy drug that is first used to treat advanced or metastatic non–small cell lung cancer that is ALK positive. If the cancer stops responding to crizotinib, or if you can’t take crizotinib, these targeted therapy drugs may be used.
| Approval Status | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/202570s045lbl.pdf |
| Instructions for use:dosing, indications, interactions...etc. | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/205755s011lbl.pdf |
Ceritinib is a second-generation ALK inhibitor that has demonstrated efficacy in patients with ALK-positive NSCLC, including those who have experienced disease progression on crizotinib. It is also approved for patients who cannot tolerate crizotinib or have not been previously treated with an ALK inhibitor.
| Approval Status | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/205755s011lbl.pdf |
| Instructions for use:dosing, indications, interactions...etc. | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/205755s011lbl.pdf |
Alectinib is another second-generation ALK inhibitor that has proven effective in treating ALK-positive NSCLC, particularly in patients who have developed resistance to crizotinib. Alectinib has also demonstrated a strong ability to penetrate the blood-brain barrier, making it effective against brain metastases.
| Approval Status | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208434s028lbl.pdf |
| Instructions for use:dosing, indications, interactions...etc. | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208434s028lbl.pdf |
Brigatinib is a potent ALK inhibitor approved for the treatment of ALK-positive NSCLC after crizotinib failure. It has shown efficacy in patients with brain metastases and has a manageable safety profile.
| Approval Status | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208772s005lbl.pdf |
| Instructions for use:dosing, indications, interactions...etc. | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208772s005lbl.pdf |
Lorlatinib is a third-generation ALK inhibitor that has demonstrated activity against ALK-positive NSCLC, even in patients who have experienced disease progression on prior ALK inhibitors. It is approved for the treatment of patients who have progressed on crizotinib and at least one other ALK inhibitor or who cannot tolerate other ALK inhibitors.
| Approval Status | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/210868s007lbl.pdf |
| Instructions for use:dosing, indications, interactions...etc. | https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/210868s007lbl.pdf |
These targeted drugs have significantly improved the outcomes for patients with ALK-positive NSCLC. However, patients may eventually develop resistance to these treatments, and further research is needed to identify novel therapies that can overcome this resistance. Always consult with a healthcare provider to determine the best treatment options for your specific situation.
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