ALK G1202R is a solvent-front mutation conferring resistance to 1st/2nd-gen ALK-TKIs (cri...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-ALK-G1202R-NSCLC |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-NSCLC |
| Sources | SRC-CIVIC SRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025 |
Actionability Facts
| Biomarker | BIO-ALK-FUSION |
|---|---|
| Variant | G1202R (acquired resistance) |
| Disease | DIS-NSCLC |
| ESCAT tier | IB |
| Recommended combinations | lorlatinib monotherapy |
| Contraindicated monotherapy | crizotinib (resistant), alectinib (resistant), brigatinib (resistant), ceritinib (resistant) |
| Evidence summary | ALK G1202R is a solvent-front mutation conferring resistance to 1st/2nd-gen ALK-TKIs (crizotinib, alectinib, brigatinib, ceritinib). Lorlatinib remains active and is the standard salvage TKI (Shaw 2019). Acquired G1202R is the most common resistance mutation after alectinib failure (~20-40%). |
Notes
OncoKB R1 (FDA-recognized resistance biomarker). ctDNA at progression is preferred to detect resistance; tissue rebiopsy if ctDNA negative. Compound mutations G1202R+L1196M emerge after lorlatinib — investigate 4th-gen ALK-TKIs (NVL-655) or chemotherapy salvage.
Used By
No reverse references found in the YAML corpus.