Resistance mechanisms in anaplastic lymphoma kinase-positive lung cancer

Abstract

Non-small cell lung cancer has been discovered to have many unique molecular subsets that are associated with different phenotypic behaviors and overall prognoses. In particular, anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancers (NSCLCs) have distinctive presentations and disease courses. Patients with ALK NSCLC are typically younger, have significantly less smoking exposure, and often experience prolonged survival. When patients recur, drug-tolerant persister (DTP) cells may be implicated in disease recurrence. In this review we will discuss the phenomenon of DTP related to ALK NSCLC, possible mechanistic explanations and potential treatment strategies to eliminate DTPs.

Keywords: ALK-positive lung cancer; Autophagy; Caloric restriction; Combination therapy; Drug resistance; Immune modulation; Metabolic adaptation; Mitochondrial metabolism; Tyrosine kinase inhibitors.