[Clinical practice guideline on anaplastic lymphoma kinase-tyrosine kinase inhibitors for non-small cell lung cancer (2025 edition)].

Abstract

Anaplastic lymphoma kinase (ALK) fusion represents one of pivotal driver genes within the realm of non-small cell lung cancer (NSCLC). ALK-tyrosine kinase inhibitors (ALK-TKIs) have demonstrated remarkable therapeutic efficacy for patients afflicted with ALK-positive NSCLC. As of December 31, 2024, eight ALK-TKIs, including crizotinib, ceritinib, alectinib, ensartinib, brigatinib, lorlatinib, iruplinalkib, and invonalkib have garnered approval from the China National Medical Products Administration (NMPA) (Ranking according to the approval time for marketing by NMPA), providing targeted treatment agents for ALK-positive NSCLC patients. To standardize the application of ALK-TKIs, The Chinese Association for Clinical Oncologists and the Medical Oncology Branch of China International Exchange and Promotive Association for Medical and Health Care has organized experts to compile the "Clinical practice guideline on anaplastic lymphoma kinase-tyrosine kinase inhibitors for non-small cell lung cancer (2025 edition)". This guideline provides recommendations in four aspects, encompassing ALK fusion testing, ALK-TKI targeted therapy, ALK-TKI adverse events management, and patient post-treatment follow-up, thus serving as a valuable reference for the standardized treatment of Chinese ALK fusion-positive NSCLC.

间变性淋巴瘤激酶（ALK）融合是非小细胞肺癌（NSCLC）重要的驱动基因之一。ALK酪氨酸激酶抑制剂（ALK-TKI）对ALK融合基因阳性NSCLC患者有显著疗效。截至2024年12月31日，克唑替尼、塞瑞替尼、阿来替尼、恩沙替尼、布格替尼、洛拉替尼、伊鲁阿克和依奉阿克共8个ALK-TKI被中国国家药品监督管理局（NMPA）批准上市（按照获得NMPA批准上市时间排序），为ALK融合基因阳性晚期NSCLC患者提供了靶向治疗药物。为规范ALK-TKI的使用，中国医师协会肿瘤医师分会和中国医疗保健国际交流促进会肿瘤内科学分会组织专家编写了《间变性淋巴瘤激酶酪氨酸激酶抑制剂治疗晚期非小细胞肺癌指南（2025版）》。指南从ALK融合基因检测、ALK-TKI靶向治疗、ALK-TKI不良反应管理以及治疗后患者随诊等4个方面给出推荐意见，为ALK融合基因阳性NSCLC患者的规范治疗提供参考。.