Abstract
The anaplastic lymphoma kinase (ALK) tyrosine kinase (TK) receptor has emerged recently as a potentially relevant biomarker and therapeutic target in solid and hematologic tumors. A variety of alterations in the ALK gene, such as mutations, overexpression, amplification, translocations, or other structural rearrangements, have been implicated in human cancer tumorigenesis. In this article we review the potential role that ALK may have in lung tumor origin, the methodology to detect the different molecular alterations, and the most important clinical aspects of ALK alterations in NSCLC patients.
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References
American Cancer Society. Cancer Facts and Figures 2011. Atlanta, GA: American Cancer Society, 2011. http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2011. Accessed 27 July 2011
Webb TR, Slavish J, George RE, Look AT et al (2009) Anaplastic lymphoma kinase: role in cancer pathogenesis and small molecule inhibitor development for therapy. Expert Rev Anticancer Ther 9:331–356
Lin E, Li L, Guan Y, Soriano R et al (2009) Exon array profiling detects EML4-ALK fusion in breast, colorectal, and non-small cell lung cancers. Mol Cancer Res 7:1466–1476
Fukuyoshi Y, Inoue H, Kita Y, Utsunomiya T, Ishida T, Mori M (2008) EML4-ALK fusion transcript is not found in gastrointestinal and breast cancers. Br J Cancer 98:1536–1539
Janoueix-Lerosey I, Lequin D, Brugieres L et al (2008) Somatic and germline activating mutations of the ALK kinase receptor in neuroblastoma. Nature 455:967–970
Soda M, Choi YL, Enomoto M, Takada S et al (2007) Identification of the transforming EML4-ALK fusion gene in nonsmall-cell lung cancer. Nature 448:561–566
Morris SW, Kirstein MN, Valentine MB et al (1995) Fusion of a kinase gene, ALK, to a nucleolar protein gene, NPM, in non-Hodgkin’s lymphoma. Science 267(5196):316–317
Li R, Morris SW (2008) Development of anaplastic lymphoma kinase (ALK) small-molecule inhibitors for cancer therapy. Med Res Rev 28(3):372–412
Kelleher FC, McDermott R (2010) The emerging pathogenic and therapeutic importance of the anaplastic lymphoma kinase gene. Eur J Cancer 46(13):2357–2368
Stoica GE, Kuo A, Aigner A, Sunitha I, Souttou B, Malerczyk C et al (2001) Identification of anaplastic lymphoma kinase as a receptor for the growth factor pleiotrophin. J Biol Chem 276:16772–16779
Stoica GE, Kuo A, Powers C, Bowden ET, Sale EB, Riegel AT et al (2002) Midkine binds to anaplastic lymphoma kinase (ALK) and acts as a growth factor for different cell types. J Biol Chem 277:35990–35998
Tartari CJ, Gunby RH, Coluccia AM et al (2008) Characterization of some molecular mechanisms governing autoactivation of the catalytic domain of the anaplastic lymphoma kinase. J Biol Chem 283:3743–3750
Lee CC, Jia Y, Li N, Sun X, Ng K, Ambing E et al (2010) Crystal structure of the ALK (anaplastic lymphoma kinase) catalytic domain. Biochem J 430:425–437
Wellstein A, Toretsky JA (2011) Hunting ALK to feed targeted cancer therapy. Nat Med 17(3):290–291
Mossé YP, Laudenslager M, Longo L et al (2008) Identification of ALK as a major familial neuroblastoma predisposition gene. Nature 455(7215):930–935
Chen Z, Sasaki T, Tan X et al (2010) Inhibition of ALK, PI3K/MEK, and HSP90 in murine lung adenocarcinoma induced by EML4-ALK fusion oncogene. Cancer Res 70(23):9827–9836
Palmer RH, Vernersson E, Grabbe C, Hallberg B (2009) Anaplastic lymphoma kinase: signalling in development and disease. Biochem J 420:345–361
Koivunen JP, Mermel C, Zejnullahu K et al (2008) EML4-ALK fusion gene and efficacy of an ALK kinase inhibitor in lung cancer. Clin Cancer Res 14:4275–4283
Shinmura K, Kageyama S, Tao H et al (2008) EML4-ALK fusion transcripts, but no NPM-, TPM3-, CLTC-, ATIC-, or TFG-ALK fusion transcripts, in non-small cell lung carcinomas. Lung Cancer 61:163–169
Takeuchi K, Choi YL, Togashi Y, Soda M, Hatano S, Inamura K et al (2009) KIF5B-ALK, a novel fusion oncokinase identified by an immunohistochemistry-based diagnostic system for ALK-positive lung cancer. Clin Cancer Res 15:3143–3149
Rikova K, Guo A, Zeng Q, Possemato A, Yu J, Haack H et al (2007) Global survey of phosphotyrosine signaling identifies oncogenic kinases in lung cancer. Cell 131:1190–1203
Ladanyi M, Cavalchire G (1996) Molecular variant of the NPM-ALK rearrangement of Ki-1 lymphoma involving a cryptic ALK splice site. Genes Chromosomes Cancer 15:173–177
De Castro-Carpeño J, Perona R, Belda-Iniesta C (2011) Treatment for ALK-mutated non-small-cell lung cancer: a new miracle in the research race. Clin Transl Oncol 13:774–779
Kasprzycka M, Marzec M, Liu X, Zhang Q, Wasik MA (2006) Nucleophosmin/anaplastic lymphoma kinase (NPM/ALK) oncoprotein induces the T regulatory cell phenotype by activating STAT3. Proc Natl Acad Sci USA 103:9964–9969
Chiarle R, Simmons WJ, Cai H et al (2005) Stat3 is required for ALK-mediated lymphomagenesis and provides a possible therapeutic target. Nat Med 11:623–629
Bai RY, Ouyang T, Miething C, Morris SW, Peschel C, Duyster J (2000) Nucleophosmin-anaplastic lymphoma kinase associated with anaplastic large-cell lymphoma activates the phosphatidylinositol 3-kinase/Akt antiapoptotic signaling pathway. Blood 96:4319–4327
Zou HY, Li Q, Lee JH et al (2007) An orally available small-molecule inhibitor of c-Met, PF-2341066, exhibits cytoreductive antitumor efficacy through antiproliferative and antiangiogenic mechanisms. Cancer Res 67:4408–4417
Armstrong F, Duplantier MM, Trempat P et al (2004) Differential effects of X-ALK fusion proteins on proliferation, transformation, and invasion properties of NIH3T3 cells. Oncogene 23:6071–6082
McDermott U, Iafrate AJ, Gray NS et al (2008) Genomic alterations of anaplastic lymphoma kinase may sensitize tumors to anaplastic lymphoma kinase inhibitors. Cancer Res 68:3389–3395
Christensen JG, Zou HY, Arango ME et al (2007) Cytoreductive antitumor activity of PF-2341066, a novel inhibitor of anaplastic lymphoma kinase and c-Met, in experimental models of anaplastic large-cell lymphoma. Mol Cancer Ther 6:3314–3322
Perner S, Wagner PL, Demichelis F et al (2008) EML4-ALK fusion lung cancer: a rare acquired event. Neoplasia 10:298–302
Salido M, Pijuan L, Martínez-Aviles L et al (2011) Increased ALK gene copy number and amplification are frequent in non-small cell lung cancer. J Thorac Oncol 6:21–27
Kwak EL, Bang YJ, Camidge DR et al (2010) Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med 363:1693–1703
Camidge DR, Bang YJ, Kwak EL et al. (2011) Progression-free survival (PFS) from a phase 1 study of crizotinib (PF-02341066) in patients with ALK-positive non-small cell lung cancer (NSCLC). J Clin Oncol 29(ASCO Meeting Abstr Suppl): Abstr 2501
Shepherd FA, Rodrigues Pereira J, Ciuleanu T et al (2005) Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 353:123–132
Hanna N, Shepherd FA, Fossella FV et al (2004) Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy. J Clin Oncol 22:1589–1597
Shaw AT, Yeap BY, Solomon BJ et al (2011) Effect of crizotinib on overall survival in patients with advanced non-small-cell lung cancer harbouring ALK gene rearrangement: a retrospective analysis. Lancet Oncol 12(11):1004–1012
Choi YL, Soda M, Yamashita Y et al (2010) EML4-ALK mutations in lung cancer that confer resistance to ALK inhibitors. N Engl J Med 363:1734–1739
Bossi RT, Saccardo MB, Ardini E et al (2010) Crystal structures of anaplastic lymphoma kinase in complex with ATP competitive inhibitors. Biochemistry 49:6813–6825
Heuckmann JM, Hölzel M, Sos ML et al (2011) ALK mutations conferring differential resistance to structurally diverse ALK inhibitors. Clin Cancer Res 17(23):7394–7401
Galkin AV, Melnick JS, Kim S, Hood TL, Li N, Li L et al (2007) Identification of NVP-TAE684, a potent, selective, and efficacious inhibitor of NPMALK. Proc Natl Acad Sci USA 104:270–275
Van Roosbroeck K, Cools J, Dierickx D et al (2010) ALK-positive large B-cell lymphomas with cryptic SEC31A-ALK and NPM1-ALK fusions. Haematologica 95:509–513
Sabbatini P, Korenchuk S, Rowand JL et al (2009) GSK1838705A inhibits the insulin-like growth factor-1 receptor and anaplastic lymphoma kinase and shows antitumor activity in experimental models of human cancers. Mol Cancer Ther 8:2811–2820
Rabindran SK, Sabbatini P, Korenchuk et al. (2010) Characterization of GSK1838705A, a small molecule inhibitor of the insulin-like growth factor-1 receptor and anaplastic lymphoma kinase that delays growth of IGF-1R-dependent tumors and causes regression of ALK-dependent tumors in vivo. Proceedings of the 100th annual meeting of the American association for cancer research (AACR), Denver, CO, 27–30 September 2010
Pulford K, Morris SW, Turturro F (2004) Anaplastic lymphoma kinase proteins in growth control and cancer. J Cell Physiol 199:330–358
Ardini E, Menichincheri M, De Ponti C et al. (2009) Characterization of NMS-E628, a small molecule inhibitor of anaplastic lymphoma kinase with antitumor efficacy in ALK-dependent lymphoma and non-small cell lung cancer models. Mol Cancer Therapeutics 8(12 Suppl 1): abstr 243
Shakespeare WC, Fantin VR, Wang F et al. (2009) Discovery of potent and selective orally active inhibitors of anaplastic lymphoma kinase (ALK). Proceedings of the 100th annual meeting of the American association for cancer research (AACR), Denver, CO, 27–30 September 2010, abstract 3738
Rivera VM, Anjum R, Wang F et al. (2010) Efficacy and pharmacodynamic analysis of AP26113, a potent and selective orally active inhibitor of anaplastic lymphoma kinase (ALK). Proceedings of the 101th annual meeting of the American association for cancer research (AACR), Washington, DC, 17–21 April 2010, poster 3623
Zhang S, Wang F, Keats J, Ning Y, Wardwell SD (2010) AP26113, a potent ALK inhibitor, overcomes mutations in EML4-ALK that confer resistance to PF-02341066 (PF1066). Proceedings of the 101th annual meeting of the American association for cancer research (AACR), Washington, DC, 17–21 April 2010, poster LB-298
Rodig SJ, Mino-Kenudson M, Dacic S et al (2009) Unique clinicopathologic features characterize ALK-rearranged lung adenocarcinoma in the western population. Clin Cancer Res 15:5216–5223
Choi YL, Takeuchi K, Soda M et al (2008) Identification of novel isoforms of the EML4-ALK transforming gene in non-small cell lung cancer. Cancer Res 68:4971–4976
Conflict of interest
Luis Cabezón-Gutiérrez, Parham Khosravi-Shahi, Victor Manuel Diaz-Muñoz-de-la-Espada, Jose Rafael Carrión-Galindo, Itziar Eraña-Tomás, and María Castro-Otero have no conflicts of interest or financial ties to disclose.
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Cabezón-Gutiérrez, L., Khosravi-Shahi, P., Diaz-Muñoz-de-la-Espada, V.M. et al. ALK-Mutated Non-Small-Cell Lung Cancer: A New Strategy for Cancer Treatment. Lung 190, 381–388 (2012). https://doi.org/10.1007/s00408-012-9391-y
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DOI: https://doi.org/10.1007/s00408-012-9391-y