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Revisiones en Cáncer 00041 / http://dx.doi.org/10.20960/revcancer.00041
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Opciones terapéuticas para el cáncer de pulmón con reordenamiento de ALK o ROS1 (+). Primera línea y manejo de la progresión

Enric Carcereny, Marc Cucurull, Pau Guillén

Prepublicado: 2023-11-10
Publicado: 2024-02-09
VOLUMEN 37, NÚM. 4, julio-agosto (2023), PAG. 180-191

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Hace 20 años, el descubrimiento de los mecanismos de adicción oncogénica supuso un cambio de paradigma en el abordaje y en el tratamiento de los pacientes con cáncer de pulmón. Las primeras alteraciones que se descubrieron fueron las mutaciones de EGFR. Su descubrimiento y tratamiento específico con inhibidores tirosina-cinasa (ITQ) consiguieron cambiar la historia natural del cáncer de pulmón. A esta alteración le siguieron muchas otras alteraciones moleculares, como ALK, ROS1, MET, NTKR, BRAF, HER2, KRAS, etc. En todas ellas, cuando se tratan de manera adecuada con fármacos diana, se reproducen los datos de eficacia en tasa de respuesta, en supervivencia libre de progresión y en calidad de vida, e incluso, en algunos estudios, se demuestra un beneficio en supervivencia global. En el caso concreto de los carcinomas de pulmón con reordenamiento de ALK o de ROS1, estos datos se han confirmado en varios estudios, que se detallan en esta revisión. A pesar de todos estos avances, muchos son los retos que quedan en este subgrupo de pacientes, tanto en el diagnóstico como en el tratamiento, tanto de primera línea como a la progresión o el acceso a los fármacos.

Palabras Clave: Reordenamiento de ALK. Reordenamiento de ROS1. Inhibidores de tirosina-cinasa.



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