Treatment of ALK-Positive Anaplastic Large Cell Lymphoma Refractory to Brentuximab Vedotin

This protocol covers the management of anaplastic large cell lymphoma (ALCL) in patients whose disease is anaplastic lymphoma kinase (ALK)-positive — a molecularly defined subtype with distinct biology and specific treatment considerations, including when standard approaches are no longer effective.

Clinical scenario: Anaplastic large-cell lymphoma that is anaplastic lymphoma kinase (ALK)-positive, specifically addressing evidence-based options for patients who are refractory to brentuximab vedotin.

Approach (partial): For ALK-positive ALCL refractory to brentuximab vedotin, targeted therapy with ALK inhibitors is a recommended class of intervention to consider. Chemotherapy-based salvage options and, for appropriate patients, consolidation with stem cell transplantation are also part of the decision framework — the full sequencing and eligibility criteria are in the complete protocol.

References

DOI: 10.1016/j.annonc.2025.07.014

  • First-line treatment of ALK-positive ALCL:
  • For patients with ALK-positive ALCL refractory to BV, ALK inhibitors should be considered [III, A].
  • ChT (e.g. DHAP, ICE or IVAC-MTX) is also an option [III, B].
  • For transplant-eligible patients with PTCL or ALCL, consolidation with alloSCT can be considered [II, B].
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