- |||||||||| Clinical, Review, Journal: Safety and Tolerability of Anaplastic Lymphoma Kinase Inhibitors in Non-Small-Cell Lung Cancer. (Pubmed Central) - Jun 30, 2019
Furthermore, third-generation inhibitors are currently under development to overcome acquired resistance mechanisms inevitably resulting from treatment with first- and second-generation tyrosine kinase inhibitors. Therefore, this article aims to provide a comprehensive state-of-the-art review about the pharmacodynamics, pharmacokinetics, safety, and tolerability profiles of currently available and promising under-development anaplastic lymphoma kinase tyrosine kinase inhibitors.
- |||||||||| Zykadia (ceritinib) / Novartis, R-(-)-gossypol (AT 101) / Ascenta
Journal: Anaplastic Lymphoma Kinase Confers Resistance to BRAF Kinase Inhibitors in Melanoma. (Pubmed Central) - Jun 24, 2019 Residual BRAFi and ALKi dual resistant melanoma cells from ceritinib-treated mice were sensitive to a broad-spectrum anti-apoptotic protein inhibitor, AT101. Collectively, our results provide a framework for treating BRAF-mutant melanoma that sequentially uses different targeted therapies based on post-treatment tumor evolution.
- |||||||||| Lorbrena (lorlatinib) / Pfizer, Xalkori (crizotinib) / Pfizer, Zykadia (ceritinib) / Novartis
Clinical, Journal: Capture-based ultra-deep sequencing in plasma ctDNA reveals the resistance mechanism of ALK inhibitors in a patient with advanced ALK-positive NSCLC. (Pubmed Central) - Jun 20, 2019 Collectively, our results provide a framework for treating BRAF-mutant melanoma that sequentially uses different targeted therapies based on post-treatment tumor evolution. Clinical evidence and in vitro validation revealed the clinical usefulness of captured-base ultra-deep sequencing on longitudinal plasma ctDNA in revealing the underlying resistance mechanism and guiding the precise administration of ALK inhibitors in patients with advanced ALK-positive NSCLC.
- |||||||||| Retrospective data, Journal: Anaplastic lymphoma kinase inhibitors in non-small cell lung cancer patients with brain metastases: a meta-analysis. (Pubmed Central) - Jun 11, 2019
Five randomized studies assessed the intracranial efficacy of anti-ALK agents versus chemotherapy, the pooled RR for iORR was 3.54 (95% CI: 2.38-5.26), and the pooled HR for iPFS was 0.52 (95% CI: 0.36-0.75; P=0.71) estimated in 2 studies. Despite the limitation from lack of published clinical data, our results showed that ALK inhibitors are effective at the brain site regardless of previous anti-ALK treatments, systemic therapy with ALK inhibitors should be considered as a preferred approach over for controlling BMs from ALK-positive NSCLC.
- |||||||||| Trial completion, Enrollment change: Capmatinib, Ceritinib, Regorafenib, or Entrectinib in Treating Patients With BRAF/NRAS Wild-Type Stage III-IV Melanoma (clinicaltrials.gov) - May 31, 2019
P2, N=1, Completed, It is suggested, in this study, that the G1123S and F1174C mutations can induce the conformational change of P-loop thereby causing the reduced ceritinib affinity and causing drug resistance. Recruiting --> Completed | N=44 --> 1
- |||||||||| Zykadia (ceritinib) / Novartis, Pomalyst (pomalidomide) / Celgene
Journal: Chemically Induced Degradation of Anaplastic Lymphoma Kinase (ALK). (Pubmed Central) - May 29, 2019 We demonstrate that in some cell types degrader potency is compromised by expression of drug transporter ABCB1. In addition, proteomic profiling demonstrated that these compounds also promote the degradation of additional kinases including PTK2 (FAK), Aurora A, FER, and RPS6KA1 (RSK1).
- |||||||||| Zykadia (ceritinib) / Novartis
Journal: Discovery of novel mutant-combating ALK and ROS1 dual inhibitors bearing imidazolidin-2-one moiety with reasonable PK properties. (Pubmed Central) - May 29, 2019 Aiming to identify novel potent ALK and ROS1 dual inhibitors, the relatively bulky piperidine fragment in ceritinib was replaced with substituted imidazolidin-2-one moiety which gave rise to a series of 2,4-diaryl-aminopyrimidine (DAAP) analogs (6-33)...Importantly, pharmacokinetic (PK) profiles of 15 were obtained with quite satisfying AUC and C values. Besides, the binding models of 15 with ALK, ALK and ROS1 clearly present the essential interactions within the active site.
- |||||||||| SHP099 / Novartis, Lorbrena (lorlatinib) / Pfizer, Zykadia (ceritinib) / Novartis
Journal: SHP2 inhibition restores sensitivity in ALK-rearranged non-small-cell lung cancer resistant to ALK inhibitors. (Pubmed Central) - May 22, 2019 Treatment with SHP099, the recently discovered small-molecule inhibitor of SHP2, in combination with the ALK tyrosine kinase inhibitor (TKI) ceritinib halted the growth of resistant PDCs through preventing compensatory RAS and ERK1 and ERK2 (ERK1/2) reactivation. These findings suggest that combined ALK and SHP2 inhibition may be a promising therapeutic strategy for resistant cancers driven by several different ALK-independent mechanisms underlying resistance.
- |||||||||| Biomarker, Journal, PD(L)-1 Biomarker, IO Biomarker: Tissue and Blood Biomarkers in Lung Cancer: A Review. (Pubmed Central) - May 2, 2019
For predicting response to single agent pembrolizumab in the first-line treatment of patients with advanced adenocarcinoma or squamous cell NSCLCs, PD-L1 should be measured by an approved assay (e.g., PD-L1 IHC 22C3 pharmDx method)...Serum biomarkers may also be of use in determining prognosis and monitoring response to systemic therapies. With the increasing use of biomarkers, personalized treatment especially for patients with adenocarcinoma-type NSCLC is finally on the horizon.
- |||||||||| Clinical, Journal: Treatment of ALK-positive nonsmall cell lung cancer: recent advances. (Pubmed Central) - Apr 26, 2019
Our review will discuss the recent phase III data with ceritinib and alectinib as well as clinical trials with other ALK inhibitors. We will also address two important issues in the management of ALK-positive NSCLC, prevention and treatment of brain metastases and management of emergent ALK-TKI resistance mechanisms.
- |||||||||| Zykadia (ceritinib) / Novartis
Enrollment closed, Enrollment change, Combination therapy, Metastases: Ceritinib and Combination Chemotherapy in Treating Patients With Advanced Solid Tumors or Locally Advanced or Metastatic Pancreatic Cancer (clinicaltrials.gov) - Apr 19, 2019 P1, N=38, Active, not recruiting, Recruiting --> Active, not recruiting Recruiting --> Active, not recruiting | N=96 --> 38
- |||||||||| Xalkori (crizotinib) / Pfizer, Zykadia (ceritinib) / Novartis
Journal, Heterogeneity: Genomic heterogeneity of ALK fusion breakpoints in non-small-cell lung cancer. (Pubmed Central) - Apr 17, 2019 Survival analysis of patients treated with targeted ALK inhibitors demonstrates a significant difference in mean survival between patients with next-generation sequencing confirmed EML4-ALK rearrangements, and those without (20.6 months vs 5.4 months, P<0.01). Together, these data demonstrate abundant genomic heterogeneity among ALK-rearranged lung adenocarcinoma, which may account for differences in treatment response with targeted ALK inhibitors.Modern Pathology advance online publication, 12 January 2018; doi:10.1038/modpathol.2017.181.
- |||||||||| Zykadia (ceritinib) / Novartis
Enrollment change, Metastases: Ceritinib Rare Indications Study in ALK+ Tumors (clinicaltrials.gov) - Apr 16, 2019 P2, N=22, Completed, Together, these data demonstrate abundant genomic heterogeneity among ALK-rearranged lung adenocarcinoma, which may account for differences in treatment response with targeted ALK inhibitors.Modern Pathology advance online publication, 12 January 2018; doi:10.1038/modpathol.2017.181. N=106 --> 22
- |||||||||| Clinical, Review, Journal: Lung Toxicity in Non-Small-Cell Lung Cancer Patients Exposed to ALK Inhibitors: Report of a Peculiar Case and Systematic Review of the Literature. (Pubmed Central) - Apr 10, 2019
...Crizotinib was responsible for pulmonary adverse events (AEs) in 1.8% of exposed patients (49 of 2706)...Pulmonary AEs during therapy with ceritinib, alectinib, and lorlatinib occurred in 1.1%, 2.6%, and 1.8% of the patients, respectively...Lung toxicity is a rare albeit potentially severe side effect in NSCLC patients receiving ALK-TKIs, apparently more frequent with brigatinib. Its early recognition and treatment are crucial for the best outcome of this subgroup of patients, whose overall prognosis is being improved by the availability of several targeted agents.
- |||||||||| Zykadia (ceritinib) / Novartis
Enrollment change, Metastases: Ceritinib Rare Indications Study in ALK+ Tumors (clinicaltrials.gov) - Mar 5, 2019 P2, N=106, Completed, Its early recognition and treatment are crucial for the best outcome of this subgroup of patients, whose overall prognosis is being improved by the availability of several targeted agents. N=22 --> 106
- |||||||||| Zykadia (ceritinib) / Novartis
Enrollment open, Trial initiation date, Trial primary completion date: A Study of LDK378 in Patients With Non-small Cell Lung Cancer Harboring ROS1 Rearrangement (clinicaltrials.gov) - Jan 11, 2019 P2, N=46, Recruiting, Trial completion date: Dec 2018 --> Dec 2019 | Trial primary completion date: Dec 2018 --> Dec 2019 Not yet recruiting --> Recruiting | Initiation date: Jan 2018 --> Jul 2018 | Trial primary completion date: Dec 2019 --> May 2020
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