Understanding plasma molecular profiling in lung cancer resistant to ALK inhibitors

Plasma Molecular Profiling in ALK Inhibitor Resistant Non-Small Cell Lung Cancer

Observational National Cancer Centre, Singapore · NCT04087473

This study is trying to see if analyzing blood samples from patients with advanced lung cancer who didn't respond to ALK inhibitors can help find better treatment options for them.

Quick facts

Study typeObservational
Enrollment50 (estimated)
Ages21 Years and up
SexAll
SponsorNational Cancer Centre, Singapore Academic / other
Drugs / interventionsCeritinib, Alectinib, Brigatinib, Ensartinib, radiation
Locations5 sites (Hong Kong and 4 other locations)
Trial IDNCT04087473 on ClinicalTrials.gov

What this trial studies

This observational study aims to conduct comprehensive molecular profiling of plasma samples from patients with advanced ALK-positive non-small cell lung cancer (NSCLC) who have progressed after treatment with 1-2 ALK inhibitors. The goal is to analyze secondary mutations that contribute to ALK resistance, thereby guiding subsequent treatment selection. By utilizing advanced techniques such as the Guardant360 assay and next-generation sequencing, the study seeks to improve clinical outcomes for patients by matching them with the most effective ALK inhibitors based on their unique molecular profiles.

Who should consider this trial

Good fit: Ideal candidates include patients aged 21 and older with advanced ALK fusion oncogene positive lung adenocarcinoma who have progressed after 1-2 ALK inhibitors.

Not a fit: Patients who have received more than 2 prior ALK inhibitors may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to more personalized and effective treatment options for patients with ALK-positive NSCLC.

How similar studies have performed: Other studies utilizing molecular profiling and next-generation sequencing have shown promise in improving treatment outcomes for similar patient populations.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients with advanced ALK fusion oncogene positive lung adenocarcinoma that have progressed after 1-2 ALK inhibitors, with at least one prior line of 2nd generation ALKi (i.e. Ceritinib, Alectinib, Brigatinib or Ensartinib)
* The availability of sufficient plasma
* Age ≥ 21 years
* WHO performance status ≤ 2
* Life expectancy of ≥ 21 weeks
* Patients should have adequate organ function for potential consideration into clinical trials (routine blood tests are valid within 14 days before enrollment):

  1. Adequate bone marrow function as shown by: ANC ≥ 1.0x10\^9/L, Platelets ≥ 75x10\^9/L, Hb ≥ 7.5 g/dL
  2. Alanine aminotransferase (ALT) and aspirate aminotransferase (AST) normal range (or ≤ 3.0xULN if liver metastases are present)
* Willing to provide signed informed consent
* Patients whom do not fulfill the above criteria may be discussed on a case-by-case basis within the study team, for potential enrolment

Exclusion Criteria:

* Received more than 2 prior ALK inhibitors (ALKi)
* Symptomatic or uncontrolled brain metastases requiring concurrent treatment inclusive but not limited to surgery and radiation. Stable/ tailing doses of corticosteroids is permitted

Where this trial is running

Hong Kong and 4 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Non-small Cell Lung CancerALK-Positive Lung CancerALK inhibitorNSCLCAnaplastic lymphoma kinase fusion oncogene NSCLCGuardant360 assayNext-Generation Sequencing DNA sequencing testCell-free circulating tumor DNA
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.