About ALK+ advanced non-small cell lung cancer (NSCLC)

Each year, there are 1.8 million people diagnosed worldwide with lung cancer, the leading cause of cancer death.1 The most common type of lung cancer is non-small cell lung cancer (NSCLC), accounting for 9 out of 10 cases.2 Advances in genetic research have revealed that NSCLC is not a single disease, but rather many types of cancer with specific genetic differences. Because of these small but important differences, lung cancer medicines that target specific genes, such as anaplastic lymphoma kinase (ALK), can be developed. About 2-7% of people with NSCLC have the ALK gene rearrangement.3

Treating ALK+ advanced non-small cell lung cancer (NSCLC)

Targeted medicine has changed the treatment of ALK+ NSCLC by blocking the action of the altered ALK gene to help shrink or slow cancer growth. However, studies have shown that patients may experience disease progression, where their cancer may continue to grow or spread, less than a year after starting treatment with their first ALK inhibitor.3 For patients with ALK+ NSCLC, the most common sites of disease progression (or metastasis) include brain, liver and bone. Brain metastases in particular can affect up to 50% of patients with ALK+ NSCLC.4 Today, there are targeted medicines available for patients who have experienced progression.

Experiencing lung cancer symptoms, including cough, shortness of breath, tiredness, pain, and anorexia, may indicate a relapse or progression of disease.1

Questions to ask your doctor

When you are diagnosed with ALK+ advanced NSCLC, you may want to ask your doctor questions like these about your diagnosis and treatment plan:

If lung cancer is newly diagnosed:

  • What type of lung cancer do I have?
  • What stage is my lung cancer?
  • How can I get tested for genetic alterations like ALK?
  • What does ALK+ mean?
  • What are my treatment choices?
  • What are the expected benefits of each kind of treatment?
  • What are the risks of each treatment?
  • What are the side effects of each treatment?
  • How will we know if treatment is working?
  • How will each treatment affect my daily life?
  • Which treatments or clinical trials should I consider?

If you've had prior treatment with an ALK inhibitor and are concerned about disease progression:

  • How will I know if my cancer has become resistant to treatment?
  • How does drug resistance develop?
  • How will I know if my cancer is progressing?
  • What are the symptoms of disease progression?
  • Are there tests I need to take to determine if my disease is progressing?
  • If I become resistant to my current ALK inhibitor, what are my other treatment options?
  • How will I know when it's appropriate for me to begin another treatment option?


  1. World Health Organization. Cancer. Fact Sheet No 297. February 2014.
  2. American Cancer Society. Detailed Guide: Lung Cancer (Non-Small Cell) 2013. http://www.cancer.org/acs/groups/cid/documents/webcontent/003115-pdf.
  3. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Non-Small Cell Lung Cancer. NCCN 2014 3:1-148.
  4. Rangachari D, Yamaguchi N, VanderLaan PA. Brain metastases in patients with EGFR-mutated or ALK-rearranged non-small-cell lung cancers. Lung Cancer. April 2015; 88(1):108-11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25682925?dopt=Abstract