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EML4-ALK variant 1 (E13;A20) is a stable fusion isoform with longer PFS on 2nd-gen ALK-TK...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDBMA-ALK-EML4-V1-NSCLC
TypeActionability
Statusreviewed 2026-04-27 | pending_clinical_signoff | actionability review required
DiseasesDIS-NSCLC
SourcesSRC-CIVIC SRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025

Actionability Facts

BiomarkerBIO-ALK-FUSION
VariantEML4-ALK variant 1 (E13;A20)
DiseaseDIS-NSCLC
ESCAT tierIA
Recommended combinationsalectinib monotherapy, lorlatinib monotherapy
Evidence summaryEML4-ALK variant 1 (E13;A20) is a stable fusion isoform with longer PFS on 2nd-gen ALK-TKIs vs variant 3. Standard 1L is alectinib or lorlatinib; v1 patients show particularly durable responses to alectinib (~3-year median PFS in subset analyses of ALEX and J-ALEX).

Notes

ESCAT IA. Variant typing not strictly required for 1L decision but informs prognosis and surveillance intensity. RNA-NGS reports variant.

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