Update of Diagnosis and Targeted Therapy for ALK+ Inflammation Myofibroblastic Tumor

Curr Treat Options Oncol. 2023 Dec;24(12):1683-1702. doi: 10.1007/s11864-023-01144-6. Epub 2023 Nov 8.

Abstract

OPINION STATEMENT: Inflammatory myofibroblastic tumor (IMT), characterized by intermediate malignancy and a propensity for recurrence, has presented a formidable clinical challenge in diagnosis and treatment. Its pathological characteristics may resemble other neoplasms or reactive lesions, and the treatment was limited, taking chemotherapies as the only option for those inoperable. However, discovering anaplastic lymphoma kinase (ALK) protein expression in approximately 50% of IMT cases has shed light on a new diagnostic approach and application of targeted therapies. With the previous success of combating ALK+ non-small-cell lung cancers with ALK tyrosine kinase inhibitors (TKIs), crizotinib, a first-generation ALK-TKI, was officially approved by the U.S. Food and Drug Administration in 2020, to treat unresectable ALK+ IMT. After the approval of crizotinib, other ALK-TKIs, such as ceritinib, alectinib, brigatinib, and lorlatinib, have proven their efficacy on ALK+ IMT with sporadic case reports. The sequential treatments of targeted therapies in may provide the insight into the choice of ALK-TKIs in different lines of treatment for unresectable ALK+ IMT.

Keywords: Alectinib; Anaplastic lymphoma kinase; Brigatinib; Ceritinib; Crizotinib; Inflammatory myofibroblastic tumor; Lorlatinib.

Publication types

  • Review

MeSH terms

  • Anaplastic Lymphoma Kinase
  • Antineoplastic Agents* / therapeutic use
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Crizotinib / therapeutic use
  • Humans
  • Inflammation / diagnosis
  • Inflammation / drug therapy
  • Inflammation / etiology
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / metabolism
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Protein-Tyrosine Kinases
  • Receptor Protein-Tyrosine Kinases

Substances

  • Anaplastic Lymphoma Kinase
  • Crizotinib
  • Receptor Protein-Tyrosine Kinases
  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Protein-Tyrosine Kinases