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    Association details:
    Biomarker:ALK L1196M
    Cancer:Non Small Cell Lung Cancer
    Drug:Xalkori (crizotinib) (ALK inhibitor)
    Direction:Resistant
    Evidence:
    Evidence Level:
    Resistant: C3 – Early Trials
    New
    Source:
    ScienceDirect
    Title:

    Multiplexed deep sequencing analysis of ALK kinase domain identifies resistance mutations in relapsed patients following crizotinib treatment

    Excerpt:
    ...genomic DNA analysis from thirteen relapsed patients revealed three known crizotinib resistance mutations, C1156Y, L1196M and G1269A.
    DOI:
    10.1016/j.ygeno.2013.02.006
    Evidence Level:
    Resistant: C3 – Early Trials
    New
    Source:
    Transl Cancer Res
    Title:

    Molecular resistance mechanisms of ALK inhibitors and implications for therapeutic management of ALK-rearranged lung cancer patients

    Excerpt:
    In this study crizotinib resistance mutations were confirmed in 11 (20%, N=51) specimens from biopsy sites that included pleural fluid (31%), liver (22%), and nodal tissue (18%) from 10 patients. L1196M and G1269A mutations represented the most common mutations with a frequency of 7% and 4% of the total mutations detected, respectively.
    DOI:
    10.21037/tcr.2017.03.22
    Evidence Level:
    Resistant: C4 – Case Studies
    New
    Source:
    J Thorac Oncol
    Title:

    Expanded CTCs from a Patient with ALK Positive Lung Cancer Present EML4-ALK Rearrangement along with Resistance Mutation and Enable Drug Sensitivity Testing: A Case Study

    Excerpt:
    Whole-exome sequencing (70–100× coverage) of the biopsy revealed a secondary mutation L1196M and resultant resistance to crizotinib.
    DOI:
    10.1016/j.jtho.2016.07.027