TY - JOUR A1 - Hempel, Louisa A1 - Molnar, Jakob A1 - Gaumann, Andreas A1 - Robert, Sebastian A1 - Scheiber, Josef A1 - Kleespies, Axel A1 - Riedmann, Kristina A1 - Schreiber, Susanne A1 - Gandorfer, Beate A1 - Piehler, Armin A1 - Hempel, Dirk T1 - Detection of acquired resistance mutation ALK G1202R after treatment with alectinib and response of lorlatinib BT - A case report JF - memo - Magazine of European Medical Oncology N2 - In the era of personalized medicine, the identification of driver mutations has paved the way towards targeted therapy. With the identification of anaplastic lymphoma kinase (ALK) as an oncogenic driver mutation, ALK rearrangements became druggable by tyrosine kinase inhibitors and, thus, have improved the prognosis for patients. Nevertheless, these approaches are limited by resistances occurring within the first or second year of administering ALK inhibitors. Among the different ALK resistant mutations, G1202R is the most common mutation, located in the kinase domain of the ALK protein resulting in resistance to treatment with the first- and second-generation kinase inhibitors (e.g., crizotinib, ceritinib, brigatenib and alectinib). Conflicting reports exist regarding the efficacy of lorlatinib, a next generation ALK inhibitor. The aim of this study is to access the potential impact of lorlatinib as a second-line treatment for a metastatic progressive NSCLC disease harboring genomic alteration of ALK G1202R, an AKLi-resistant mutation. The case of a patient with advanced lung cancer and the mentioned mutation is described. KW - NSCLC KW - Next-generation ALK inhibitor KW - Resistance mechanisms KW - Next-generation sequencing KW - Molecular diagnostics Y1 - 2021 UR - https://doi.org/10.1007/s12254-021-00724-2 ER -