alectinib + brigatinib + ceritinib + lorlatinib

This is a **combination drug** consisting of four ALK tyrosine kinase inhibitors: **alectinib, brigatinib, ceritinib, and lorlatinib**. All are **small molecule targeted therapies** used for the treatment of **ALK-positive non-small cell lung cancer (NSCLC)**. Each component acts as an inhibitor of the anaplastic lymphoma kinase (**ALK**) receptor tyrosine kinase, blocking oncogenic signaling, cell proliferation, and survival in ALK-rearranged tumors. Alectinib, brigatinib, and ceritinib are **second-generation ALK inhibitors**, developed for use after progression on first-generation ALK inhibitors (notably crizotinib), with documented improved efficacy and CNS penetration. Lorlatinib is a **third-generation ALK inhibitor** that retains high selectivity for ALK and is specifically designed to overcome resistance mutations, including G1202R, seen after previous ALK inhibitor therapy. All four agents are orally administered and have individually received regulatory approval for ALK-positive NSCLC. Combination use of these agents is experimental, proposed for overcoming acquired resistance and heterogeneity in ALK mutations.