Genentech's lung cancer drug Alecensa received FDA's conditional approval for the treatment
of ALK - positive lung cancer.
The test uses dyes — in this case orange and green — that bind to separate halves
of the ALK gene.
Partnering with the U.S. Food and Drug Administration allowed Doebele and colleagues to access clinical trial data describing initial tumor response, PFS and OS for 305 patients with stage IIIb or IV non-small cell lung cancer on trials
of ALK inhibitors and 355 similar patients on trials of immunotherapies directed at PD - 1.
«Although still only in an early phase trial, brigatinib is showing an objective response rate in approximately 70 percent
of ALK - positive patients post-crizotinib and it's showing about a year of progression - free survival.
Among patients with non-small cell lung cancer (NSCLC) fueled by ALK gene alterations who were being treated with crizotinib (Xalkori), a decrease in the number of circulating tumor cells (CTCs) harboring increased copies
of the ALK gene over the first two months of treatment was associated with increased progression - free survival.
After enriching for CTCs, the researchers analyzed the samples for ALK rearrangements and for an increase in the number of copies
of the ALK gene.
In his own practice, Chirieac is routinely examining for the presence
of ALK rearrangements for patients with mesothelioma and educating his residents about this new finding.
Chirieac and colleagues hope to extend their study
of ALK - positive mesotheliomas in a global patient population.
The woman's tumour had a genetic rearrangement that produced a misshapen version
of the ALK protein, so her doctors first administered the drug crizotinib, which inhibits the action of ALK.
For example, a fusion
of ALK with EML4 occurs in about 5 % of cancers and is linked to strong patient response to treatment with crizotinib.
Not exact matches
And although AirMap's 26 employees are just a fraction
of the roughly 13,000 people that Alaska Air Group (
alk) employed during Ayer's tenure as CEO, there are some similarities.
Companies Reporting Before The Bell Alaska Air Group, Inc. (NYSE:
ALK) is expected to report its quarterly earnings at $ 1.33 per share on revenue
of $ 1.42 billion.
And remember, I'm not
alking about the religion
of Christianity, but the aspect
of my life where I believe in Jesus for eternal life, and try to follow His leading and His example.
This thing is being given too much attention.There a lot
of players Arsenal passed up on that Mourinho may have also signed you know.In fact there a lot
of top players who Arsenal passed up on signing when they were young and for some even matured.Does this mean they aren't good enough?Wenger even regrets passing up on certain players.The fact is that everyone has his basis for signing or not signing a player.Clearly, Wenger and Mourinho both have their basis on whether Lacazette was good enough.One player who is deemed average to another team could be deemed useless to another team.I just don't know why much attention is being given to this thing.One thing I know for sure is Laca is a good finisher and that's
alk he needs this season.If Lacazette brings his finishing boots this season it's going to be goals galore.
«Rare genetic cause
of peritoneal mesothelioma points to targeted therapy: Genetic rearrangement in the
ALK gene found in young women with mesothelioma may be targetable with FDA - approved drugs.»
They also looked in samples collected from patients with pleural mesothelioma — the more common form
of the diseases — but none
of those samples were positive for
ALK.
The
ALK gene is important during embryonic development
of the nervous system but should be inactive later in life.
Three patient samples were positive for
ALK — these patients with peritoneal mesothelioma were women with no history
of asbestos or radiation therapy exposure.
Previous studies
of genetic alterations in lymphoma and lung cancer have found that certain genetic mutations — specifically when part
of a gene breaks off and gets fused to another — can inappropriately switch on
ALK, driving cancer cells to grow and divide.
They identified
ALK - positive mesotheliomas by immunohistochemistry; confirmed with fluorescence in situ hybridization; and performed targeted next - generation sequencing
of tumor DNA and RNA to get a full picture
of the exact genetic rearrangement underpinning the disease.
Now, through an unexpected observation and a meticulous study
of patients seen at Brigham and Women's Hospital, BWH investigators have added a fourth cause to the list: a genetic rearrangement in the
ALK gene, observed in three patients with peritoneal mesothelioma.
About 4 percent
of NSCLCs are driven by genetic aberrations called
ALK gene rearrangements, according to Farace.
Of the more than 1,600 samples tested, 10.5 % had EGFR sensitizing, 18.8 % EGFR resistance, 13.2 % KRAS, and 2 % EML4 -
ALK (anaplastic lymphoma kinase) mutations.
Median progression - free survival for the 13 patients who had a decrease in the number
of CTCs with
ALK copy number gain was 14.0 months, while the median progression - free survival for the 16 patients who had stable or increased numbers
of CTCs with
ALK copy number gain was 6.1 months.
Analysis
of CTC numbers at the different time points showed that the one measurement that was statistically significantly associated with progression - free survival was a change in the number
of CTCs with
ALK copy number gain over time.
Phase I / II clinical trial results reported at the American Society for Clinical Oncology (ASCO) Annual Meeting 2015 show promising results for investigational drug brigatinib against
ALK + non-small cell lung cancer (NSCLC), with 58
of 78
ALK + patients responding to treatment, including 50
of 70 patients who had progressed after previous treatment with crizotinib, the first licensed
ALK inhibitor.
These results are among the best in the field, offering a lot
of hope to people with
ALK - positive lung cancer,» says D. Ross Camidge, MD, PhD, director
of thoracic oncology at the University
of Colorado Cancer Center and the trial's principal investigator.
«We look forward to conducting further research through the STARTRK - 2 phase II trial and are hopeful that treatment with entrectinib in patients with a range
of advanced or metastatic solid tumors harboring NTRK1 / 2/3, ROS1, or
ALK gene fusions will result in very meaningful benefit.»
Some patients with non-small cell lung cancer (NSCLC) have changes in the anaplastic lymphoma kinase (
ALK) gene, which can drive the development
of their cancer.
Dorothy Romanus, lead author
of the study, states «this analysis supports the value
of multiplexed testing for EGFR and
ALK gene rearrangements followed by molecularly - guided therapy in decisions surrounding coverage
of related testing and targeted therapy.
Around 1,600 people are diagnosed with non-small cell lung cancer in Greater Manchester every year and a proportion
of these patients will have the
ALK - positive type.
However, the presence
of EGFR mutations and
ALK rearrangements is low in unselected NSCLC, 9.5 % and 3.9 %, respectively.
Now doctors have investigated the use
of crizotinib in patients with
ALK positive lung cancer who have not yet received any chemotherapy treatment.
The abnormality in
ALK that arises in NSCLC is not, strictly speaking, a mutation (a change in the sequence
of DNA within a gene).
The latter trial addresses one
of the most fundamental questions in the field, which is what should be the first
ALK inhibitor that patients receive.»
Although abnormal
ALK is found in only about 5 percent
of NSCLC cases, that translates into more than 5,000 new patients annually who could potentially benefit from crizotinib therapy, the study authors state.
In the group that received targeted treatment for
ALK - positive lung cancer, each category
of tumor reduction was associated with corresponding gains in PFS and OS.
«This study demonstrates the value
of testing lung cancer tissue for an
ALK rearrangement, and it underscores the potential
of cancer genomics to target cancer treatments to each patient,» says the study's senior author, Pasi A. Jänne, MD, PhD, who is the director
of the Lowe Center for Thoracic Oncology
of Dana - Farber.
For example, the drug crizotinib approved to treat
ALK - positive lung cancer, showed a PFS
of 10.9 months.
Commenting on the trial, Dr Alice Shaw, director
of thoracic oncology at the Massachusetts General Hospital Cancer Centre in Boston, US, said: «This is the first randomised study to examine how a second generation
ALK inhibitor compares to standard second line chemotherapy in
ALK positive patients who failed the standard first line therapy, which currently is crizotinib.»
She concluded: «We are now waiting on the results
of trials testing the second generation
ALK inhibitors ceritinib (versus chemotherapy) and alectinib (versus crizotinib) in the first line setting.
Now the next - generation
ALK - inhibitor, alectinib, shows PFS
of nearly 25 months.
Ceritinib provides longer progression - free survival than chemotherapy in crizotinib - pre-treated patients with non-small-cell lung cancer harbouring an
ALK rearrangement, according to results
of the phase III ASCEND - 5 study presented at the ESMO 2016 Congress in Copenhagen.
«Patients with non-small cell lung cancer (NSCLC) should receive front line therapy with the anaplastic lymphoma kinase (
ALK) inhibitor crizotinib,» said lead author Professor Giorgio Scagliotti, head
of the Department
of Oncology, University
of Turin, Italy.
The advent
of therapies directed at tumors with mutations in epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (
ALK), and B - Raf proto - oncogene (BRAF) genes over the past decade have dramatically changed outcomes, he says.
Since whole - brain radiation is associated with significant cognitive effects and the use
of additional radiation therapy for progression is common in this population, the Yale researchers suspect that patients with the
ALK mutation would benefit from radiation focused on individual metastases.
Testing for the EGFR mutation and
ALK rearrangements and the use
of targeted therapies have given lung cancer patients the chance for survival, along with improved quality
of life and time with loved ones.
The updated guideline will include new recommendations for
ALK testing by IHC,
ALK - EGFR resistance, and a number
of emerging target molecular targets which will include, but is not limited to, ROS1, MET, ERBB2, RET, NTRK1.
In October
of 2014, The American Society
of Clinical Oncology (ASCO) Clinical Practice Guidelines Committee (CPGC) endorsed the CAP / IASLC / AMP guideline for EGFR and
ALK molecular testing.
The NIH and Mass General are at the vanguard
of a major effort to identify and treat cancer based on causative gene mutations like the one found in
ALK.