ALK L1196M is the gatekeeper mutation conferring resistance to crizotinib but retaining s...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-ALK-L1196M-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 | L1196M (acquired resistance) |
| Disease | DIS-NSCLC |
| ESCAT tier | IB |
| Recommended combinations | alectinib monotherapy, brigatinib monotherapy, lorlatinib monotherapy |
| Contraindicated monotherapy | crizotinib (resistant) |
| Evidence summary | ALK L1196M is the gatekeeper mutation conferring resistance to crizotinib but retaining sensitivity to 2nd-gen ALK-TKIs (alectinib, brigatinib, ceritinib) and to lorlatinib. Historically the most common crizotinib-resistance mutation; less prevalent now that crizotinib is no longer 1L. |
Notes
OncoKB R1 (resistance to crizotinib only). Less clinically relevant in the modern era as crizotinib is no longer 1L.
Used By
No reverse references found in the YAML corpus.