If you have been told that you have ALK+ NSCLC, you might be wondering what this means.
Firstly, NSCLC stands for 'non-small cell lung cancer' – you can learn more about what this is here. About 85% of people with lung cancer have NSCLC.1
To understand what ALK+ means, we need to learn a bit more about 'DNA'.
Your body is made up of trillions of tiny building blocks called cells. Inside each cell is DNA. DNA is like a set of instructions that tell your cells what to do. They tell the cell to make certain things, when to grow or multiply, when to move around, and even when it is time to die.2
Normally your DNA helps keep your cells in a careful balance,3 so that they are multiplying and dying at a similar speed. But sometimes something goes wrong, and the DNA changes. This can cause cells to grow too fast and eventually make a tumour.2
ALK+ means that you have a change in a small part of your DNA (the small part is called a ‘gene’) that makes a protein called ALK (or 'anaplastic lymphoma kinase'). This protein is responsible for a few different things, including telling cells to grow and multiply, and move around.4,5
ALK doesn’t exist in healthy lungs – your cells would normally ignore that bit of information in your DNA. But in ALK+ NSCLC, the change in the gene means that your lung cells start making the ALK protein. When this happens, your cells start to grow and multiply out of control, and eventually they build up and become tumours.6–9
Right now, we don’t know exactly why some people develop a change in their ALK gene.
Although smoking and being exposed to second-hand smoke are some of the most well-known causes of lung cancer,15 people who develop ALK+ NSCLC have often never smoked, or may have only lightly smoked, in the past.5,16
Developing lung cancer when you have little or no smoking history can be extremely frustrating, and you might find yourself looking for answers as to why you have developed lung cancer at all.
There are a number of other factors (summarised below) that are thought to be associated with the development of NSCLCs. However, it’s important to note that for some people, there may be no obvious cause as to why they have developed ALK+ NSCLC.
Getting an accurate diagnosis is important, so your doctor will make sure you have various tests to find out as much about your cancer as possible. That way, you and they can work together to create the best possible treatment plan for you.
Tests to see if you have a change in your ALK gene will include a biopsy – you can learn more about these here.
You can learn more about how changes to your genes can cause cancer here.
When thinking about what it means to have ALK+ NSCLC, many people wonder what their prognosis is. But cancer is a highly complex disease that can be affected by lots of different factors, so it’s hard for a doctor to give anybody an exact amount of time. These factors can include:
It's worth being aware that ALK+ NSCLC is considered more aggressive than some other forms of NSCLC26 – nine out of 10 people are diagnosed after the cancer has already spread to other parts of their body (called ‘metastasis’, or ‘advanced cancer’).27,28 With regular chemotherapy, about half of people with advanced ALK+ NSCLC pass away about 2 years after their diagnosis.29
However, research has led to the discovery of modern treatments called ‘ALK inhibitors’, which are specifically designed to treat ALK+ NSCLC.30,31
These ALK inhibitors have helped increase the time that somebody can live with ALK+ NSCLC. In 2019, a clinical trial in 110 people with advanced, stage 4 ALK+ NSCLC was published. It found that with treatment, half of the patients were still alive almost 7 years later.32