New ALK Inhibitors: Advancing Hope in Lung Cancer Treatment
The fight against cancer is constantly evolving, and in recent years, a major breakthrough in Australia has been the development and local approval of targeted therapies. One such success story is the ongoing advancement of ALK inhibitors—a class of drugs designed for cancers with anaplastic lymphoma kinase (ALK) gene alterations, especially non-small cell lung cancer (NSCLC).
Today, Australians benefit from several next-generation ALK inhibitors on the market, dramatically improving treatment prospects and presenting new opportunities for research and care.
What Is ALK and Why Does It Matter?
ALK (anaplastic lymphoma kinase) is a gene which can become abnormally active due to gene fusions, most notably EML4-ALK rearrangement. This activation drives uncontrolled tumor growth. About 3–5% of NSCLC cases in Australia are ALK-positive, with these changes seen most often in younger patients with no smoking history.
ALK Inhibitors in Australia
ALK inhibitors work by blocking the abnormal activity of the ALK protein, effectively slowing or halting tumor proliferation. Australians with ALK-positive NSCLC have access to several PBS-listed options:
Crizotinib:
Approved in 2014 by the Therapeutic Goods Administration (TGA) and PBS-listed for advanced ALK-positive NSCLC.
Ceritinib:
Approved for use following progression on crizotinib.
Alectinib:
Registered by the TGA in March 2017 and PBS-listed since January 2018 for locally advanced or metastatic ALK-positive NSCLC. Its approval was based on significant tumor response and brain activity, supported by key clinical trials.
Brigatinib:
Brigatinib: Approved in 2020 for ALK-positive NSCLC and PBS-listed.
Lorlatinib:
PBS-listed since August 2020 for metastatic, ALK-positive NSCLC following earlier ALK inhibitor treatment, with expanded listing for first-line use in December 2022.
Access and Ongoing Advances
Thanks to PBS listing, these next-generation ALK inhibitors are accessible and affordable for eligible Australians. The landscape continues to evolve, with research and local evidence supporting the effectiveness of these therapies even for patients with resistance to earlier ALK inhibitors. Clinical trials in Australia continue to support ongoing discovery and adaptation of new agents for ALK-positive lung cancer.