How do you think about sequencing therapy for a patient with ALK+ metastatic NSCLC given the available options?

The types and incidence of resistance mutations vary based on the 2nd generation ALK inhibitor given, and is most commonly the G1202R mutation, which unfortunately denotes resistance to alectinib where it accounts for about 29% of acquired resistance and brigatinib where it accounts for about 43% of...

Updated answer - March 4, 2025

Given the 5-year CROWN trial update, there has been renewed interest in how to incorporate such findings into clinical practice.

In patients at high risk for early disease progression such as certain ALK variants (3a/b and 5a/b compared to the more favorable variant 1 o...

We have come a long way since the development and approval of crizotinib for ALK rearranged lung cancer. More recently, second generation ALK directed therapy including alectinib, brigatinib as well as ceritinib and ensartinib have been clinically tested and have shown improvement in outcome. More r...

The recent 7-year CROWN data update showing median PFS yet to be reached after 7 years of follow-up (55% PFS rate at 7 years) is truly unprecedented. It has become the preferred 1st line choice, especially in patients at high risk for early disease progression, such as certain ALK variants (3a/b and...