2015 Volume 55 Issue 6 Pages 956-961
Crizotinib (March 2012) and alectinib (July 2014) represent the ALK inhibitors that have been approved for use in Japan. For advanced NSCLC, the Japan Lung Cancer Society guidelines recommend to devise a treatment strategy after determining the EGFR mutation status and whether a patient is ALK fusion gene-positive. Both of the above-mentioned agents are used upon a diagnosis of whether a patient is ALK fusion gene-positive. However, the two drugs differ because they both have their own companion diagnostic agent. This can create issues in the clinical setting. For instance, if a doctor wishes to administer alectinib to a patient for whom crizotinib has been effective after an ALK fusion gene-positive diagnosis, the doctor must re-test with the alectinib companion diagnostic. Several issues come to light when one considers how to diagnose whether a patient is ALK fusion gene-positive accurately with the shortest turn around time possible in order to provide patients with the most suitable drug therapy. It is important to manage the side effects of these drugs to maximize upon their effects. In order to properly manage the side effects, it is also important to engage in treatment while ascertaining the latest side effect data as well as information such as the "Treatment guide" supplied by the pharmaceutical companies. This paper touches upon case selection and side effect management when using ALK inhibitors based upon a similarly titled presentation at the 55th Annual Meeting of the Japan Lung Cancer Society (November 2014).
