The Center for Thoracic Cancers offers patients and families access to one of New England's most experienced programs for lung cancer.
Anaplastic lymphoma kinase (ALK) positive lung cancer is a kind of non-small cell lung cancer (NSCLC) that results from a genomic abnormality. The gene for ALK is present in all of us. It plays an integral part in the development of the nervous system. When its job is done, your body deactivates the gene early in life. For individuals with ALK-positive lung cancer, ALK fuses with other genes (commonly EML4), and this event causes ALK to be re-activated. That ALK fusion leads to lung cancer.
ALK-positive lung cancer is diagnosed through a procedure called biomarker testing. If you're diagnosed with non-small cell lung cancer, your care team can take a sample of the cancer tissue and analyze it. Your medical team will look for mutations within the tumor (errors in the DNA)—called biomarkers—that indicate the activation and fusion of the ALK gene. There are multiple kinds of biomarker tests for ALK-positive lung cancer. Your doctors may use one or several of these methods to test for ALK gene mutation biomarkers.
Regardless of which specific gene the ALK gene has fused with, the course of treatment for lung cancer caused by ALK fusions is similar. Most patients start by taking an ALK inhibitor and move on to other therapies if the ALK inhibitor is no longer effective in controlling their condition or if their cancer returns after treatment.
The first-line treatment for ALK-positive lung cancer is usually a class of medicines called an ALK inhibitor. There are several different ALK inhibitors on the market, and ALK-positive lung cancer generally responds well to them.
ALK-positive lung cancer is rare, affecting only about 5% of those diagnosed with NSCLC. It is most often diagnosed in young patients, especially women, who have not smoked before.
It's natural to wonder if cancer caused by a genetic error is hereditary, but ALK lung cancer doesn't run in families the way that some other cancers—like BRCA breast cancer—do. That's because it isn't an inherited error that is present from birth. Instead, it's believed to result from outside factors, though the exact cause isn’t certain.
Each case of ALK-positive lung cancer is different. Outcomes also vary depending on the stage of the disease at diagnosis. Over the last decade, outcomes for ALK-positive lung cancer have improved dramatically due to the development of ALK targeted therapies.
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Targeted therapies induced tumor expression of the APOBEC3A protein, which was shown to directly cause new mutations and accelerate the development of drug resistance.
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