Experience in Integrating <i>ALK</i> Testing and Crizotinib into the Routine Treatment of Patients with Non-Small Cell Lung Cancer

Abstract

Background: Crizotinib, an inhibitor of the anaplastic lymphoma kinase (ALK), is approved since 2012 in Switzerland for use in ALK-rearranged advanced pretreated non-small cell lung cancer (NSCLC). Patients and Methods: Here we describe our own experience with crizotinib and ALK testing via fluorescence in-situ hybridization (FISH) in the first 10 ALK-positive patients who were treated in central Switzerland in 2011 on a compassionate use basis. Results: We have demonstrated that FISH testing for ALK can be performed simultaneously with other diagnostic procedures, providing oncologists with results in a timely manner to make informed decisions about patient treatment. The majority of our patients treated with crizotinib had a clinical benefit, and the drug was tolerated well. Conclusion: The clinical development of crizotinib has been extremely rapid. Nonetheless, by the time crizotinib was approved, many centers including our own had local testing in place and clinical experience with the drug. This emphasizes the importance of broad clinical studies and compassionate use programs in oncology.

Synergistic Effects of Crizotinib and Temozolomide in Experimental FIG-ROS1 Fusion-Positive Glioblastoma

“…With the recent US FDA approval of crizotinib, much attention has turned to FIG-ROS1-positive tumors. 18–22 Therefore, it is postulated that patients without ALK rearrangement, but amplification of c-Met or activation of other specific crizotinib targets (ROS1: an oncogenic kinase), may also benefit from crizotinib therapy. Interestingly, published interim analysis results showed no direct impact on overall survival as compared to chemotherapy; though there were high numbers of chemotherapy crossovers to crizotinib, a direct comparison was difficult.…”