Group
ALK targeting TKI
Group Profile
| Therapeutic Class | Targeted Therapy |
| Drug Class | Tyrosine Kinase Inhibitors (TKIs) |
| Mechanism of Action | ALK inhibitor |
| Drugs in group | Alectinib· Ceritinib· Brigatinib· Ensartinib· Lorlatinib |
Location
Treated site
Study design
RT–Drug Timing Window
Study design
RT–Drug Timing Window
Data: details & interpretation
“Two prospective publications[1,2] included 12 patients treated with an ALK-targeting TKI within one month of SRT to the brain, lung, spine or extremities. In nine patients the TKI was paused during SRT. One patient (8.3%), who received intracranial SRT, experienced a hgRTAE.
In summary, data remains too limited to draw conclusions.”
References (2)
- 1. Looman EL, Kroeze SGC, Schaule J, et al. Adverse Events After Metastases-Directed Stereotactic Radiotherapy and Biological Cancer Therapy. JAMA Netw Open. 2026/01/02/ 2026;9(1):e2553809. doi:10.1001/jamanetworkopen.2025.53809
- 2. Keane FK, Yeap BY, Khandekar MJ, et al. Phase 2 Trial of Consolidative Stereotactic Body Radiation Therapy in Patients With Metastatic Oncogene-driven Non-small Cell Lung Carcinoma Treated With Tyrosine Kinase Inhibitors. Int J Radiat Oncol Biol Phys. 2025/03/15/ 2025;121(4):975–979. doi:10.1016/j.ijrobp.2024.10.022
Radiobiological rationale for RT–drug interaction
ALK targeting TKIs radiosensitize selectively in EML4-ALK–driven tumors by downregulating RAS/PI3K/STAT3 survival signaling and depleting the radioresistant S-phase fraction, though this oncogene-addiction dependency means the effect is absent in ALK–wild-type cells (Dai et al., Radiotherapy and Oncology, 2015; Sun et al., Molecular Cancer Therapeutics, 2013; Fleschutz et al., Anticancer Research, 2020; Van Aken et al. ESMO Open 2026). Because sensitization is driver-restricted, the theoretical increase in normal-tissue adverse events is limited—although reduced repopulation in rapidly proliferating normal tissue could modestly enhance in-field reactions.
The data above refer to patients treated with ALK targeting TKI as the sole drug class,
excluding any concurrent use of drugs from other groups.
Combination therapy data are available in the section below.
Individual Drugs
Select a drug to view its individual evidence base (drug + SBRT, no other concurrent systemic drugs). Drugs without available data are shown greyed out.