Metastatic ALK-positive non-small cell lung cancer (NSCLC) is a form of lung cancer with tumors that contain changes to the ALK gene and have spread to other parts of the body. Read more about the outlook and treatment options.
Lung cancer is often asymptomatic. Many people do not receive a diagnosis until they begin experiencing symptoms in parts of the body other than the lungs.
However, some people do have symptoms at an early stage of this type of cancer. They may not realize that it is cancer because they or their doctor may attribute the symptoms to something else, such as an infection.
When a person receives a diagnosis at a late stage, they already have metastases — growths of cancer cells that have spread to other parts of the body.
Lung cancer metastases most commonly affect the:
- adrenal glands
In 2020, the American Lung Association reported that 47% of people who received a lung cancer diagnosis already had distant metastases, while 22% had cancer cells that had spread to nearby lymph nodes.
There are two main types of lung cancer: small cell and non-small cell (NSCLC). They differ based on the types of cells that the tumors originate from.
As researchers have learned more about lung cancer, they have identified new ways of further classifying lung cancer tumors that can help with treatment decision making and survival predictions.
By characterizing the types of genetic changes that occur in lung cancer tumors, experts have determined that people who have tumors with a genomic rearrangement of the anaplastic lymphoma kinase gene, or ALK, may do better with targeted treatment options that can improve their response to therapy.
Read on to learn more about metastatic ALK-positive NSCLC, including information on treatment and survival.
In general, NSCLC is less aggressive than small cell lung cancer, meaning people tend to live longer after diagnosis.
But survival rates for all cancers drop once cancer cells have spread to other parts of the body.
To treat lung cancer tumors that contain changes to the ALK gene, doctors may use specific medications that target the protein this gene encodes. Doctors refer to this as targeted therapy. It may offer a chance to improve survival by more specifically treating the underlying cause of disease.
One study involving 110 people with metastatic ALK-positive NSCLC found that targeted treatment with an ALK inhibitor could increase the 5-year survival rate to 60%. In this study, the median length of survival after diagnosis was 6.8 years, with some patients surviving for 10.4 years or longer.
Survival rates were similar even when brain metastases were present.
Depending on when doctors diagnose it, people can survive NSCLC. Several treatment options are available to help treat and contain the disease. These may include:
- radiation therapy
- targeted therapy
Doctors can cure lung cancer in some people if they locate the tumor early and remove it. And even when doctors cannot remove a tumor, radiation therapy can help manage the cancer and prevent it from spreading.
Once the cancer has spread, targeted therapies can help increase the length of survival.
NSCLC is the most common form of lung cancer in the United States. An estimated 82% of all U.S. lung cancer diagnoses are NSCLC.
Research suggests that about
This means that of the estimated
If doctors catch ALK-positive lung cancer early — before it has spread within the chest or to other parts of the body — and can remove the tumor, they may be able to cure it.
However, doctors catch only about
Still, treatment options for ALK-positive lung cancer can improve survival. Targeted ALK inhibitors can extend the lives of people with ALK-positive lung cancer. These medications target the protein that the ALK gene encodes, which contributes to tumor formation.
ALK inhibitors that doctors may use to treat ALK-positive lung cancer include:
- crizotinib (Xalkori)
- ceritinib (Zykadia)
- alectinib (Alecensa)
- brigatinib (Alunbrig)
- lorlatinib (Lorbrena)
Doctors can use some of these medications right away to treat ALK-positive NSCLC. They may use others later in the course of treatment if the cancer stops responding to the first medications. This can help improve the survival rate.
Lung cancer is harder to treat once it has spread beyond the lungs, but there are still options. Targeted therapies now allow doctors to treat the specific underlying causes of the disease, which can increase the survival rate and improve outcomes.
Targeted therapies can help extend the lives of people with metastatic ALK-positive NSCLC by up to several years. If a person has received a diagnosis of metastatic lung cancer, their doctor will help them determine whether these types of therapies are right for them.