Immunotherapy for ALK Positive Lung Cancer

About 5 percent of all lung cancers are ALK-positive. And about 30 percent of lung cancers in people diagnosed under age 40 are ALK-positive. People who develop ALK-positive lung cancer are often younger and have a history of light or no smoking.^1-4

What is ALK-positive lung cancer?

ALK-positive lung cancer is a type of non-small cell lung cancer (NSCLC). This type of NSCLC contains a change inside the cancer cells called a gene mutation. A gene mutation means the instructions inside the cancer cells are altered.³

In ALK-positive lung cancer, this gene mutation is in the anaplastic lymphoma kinase (ALK) gene. This mutation plays a role in abnormal cell growth that leads to cancer.³

To diagnose ALK-positive lung cancer, doctors use genetic testing called biomarker testing to find ALK mutations in lung tumor cells. The cancer is then often treated with different medicines than other types of lung cancer.^1-3

How is ALK-positive lung cancer treated?

Most people with ALK-positive lung cancer are diagnosed after the cancer has spread to other parts of the body. This is called metastatic cancer. Currently, there is no cure for metastatic ALK-positive lung cancer. However, there are effective treatments that can manage it for many years.³

The main treatment used for ALK-positive lung cancer is called targeted therapy. Targeted therapy has improved survival for people with this type of cancer. With targeted therapy, some people with metastatic ALK-positive lung cancer can live over 6 years. Compare this to a survival time for some people of 1 year without targeted therapy. And research continues to discover better treatments.^3,5

TKI targeted therapy for ALK-positive lung cancer

The targeted therapies used for ALK-positive lung cancer are drugs called tyrosine kinase inhibitors (TKI). TKIs work by blocking a protein produced by ALK-positive cancer cells. This protein plays a role in cancer development. By blocking the ALK protein, TKIs stop cancer cells from growing.^2,5

Current TKIs used to treat ALK-positive lung cancer include:²

• Alectinib
• Brigatinib
• Ceritinib
• Crizotinib
• Lorlatinib

Over time, ALK-positive lung cancer cells evolve and can become less sensitive to TKIs. Changing to a different TKI may temporarily improve your response. But eventually, TKIs will no longer work to control cancer growth. New treatments are needed that can overcome this problem.^1,2

Current immunotherapy for ALK-positive lung cancer

Immune checkpoint inhibitors (ICIs) are a type of immunotherapy used to treat certain forms of lung cancer. They work by triggering a person’s immune system to destroy cancer cells. Unfortunately, people with ALK-positive lung cancer often have a poor response to current ICIs.^1,6

TKI targeted therapy plus immunotherapy

Researchers have looked at combination therapy using targeted therapy (TKIs) plus immunotherapy (ICIs). Combining TKIs with ICIs has shown some promise.

However, side effects are significant. The most common side effects of some therapies include abnormal liver function, diarrhea, and rash. More research is needed to determine if this approach is safe and effective.¹

Immunotherapy for ALK-positive lung cancer

One treatment strategy being studied uses the body’s immune system to fight cancer. This approach uses engineered immune cells, called T cells.

To engineer the T cells, researchers first remove them from the body. Then they change the T cells in the lab to make them recognize cancer cells. When the engineered T cells are returned back into the body, they are able to seek out and attack cancer cells.^1,7

Vaccines for ALK-positive lung cancer

Researchers are also working to develop vaccines for ALK-positive cancer. They hope to create a vaccine using small pieces of a protein produced by ALK-positive cancer cells. The vaccine would then “teach” the immune system to recognize and destroy cancer cells that contain this protein.^1,8,9

Ongoing studies

Additional studies are ongoing to look into treatment that combines vaccines with other cancer therapies. Treatments being studied include:¹

• Vaccine plus immunotherapy
• Vaccine plus chemotherapy
• Vaccine plus immunotherapy and chemotherapy

ALK Positive offers up-to-date information about new treatments that are being developed.