{"id":7590,"date":"2026-10-22T16:50:12","date_gmt":"2026-10-22T09:50:12","guid":{"rendered":"https:\/\/tanyadna.id\/blog\/?p=7590"},"modified":"2026-10-22T16:50:13","modified_gmt":"2026-10-22T09:50:13","slug":"alk-pdl1-kanker-paru","status":"publish","type":"post","link":"https:\/\/tanyadna.id\/blog\/alk-pdl1-kanker-paru\/","title":{"rendered":"ALK dan PD-L1 pada Kanker Paru: Dua Biomarker, Dua Peran Berbeda"},"content":{"rendered":"\n
\"\"<\/figure>\n\n\n\n

Setelah menerima diagnosis kanker paru, pasien mungkin diminta menjalani pemeriksaan ALK dan PD-L1. Kedua nama tersebut sering tercantum dalam satu laporan biomarker, tetapi sebenarnya menggambarkan aspek tumor yang berbeda.<\/p>\n\n\n\n

ALK (anaplastic lymphoma kinase<\/em>) adalah gen yang dapat mengalami penyusunan ulang atau fusi sehingga mendorong pertumbuhan kanker. Sementara, PD-L1 (Programmed Death-Ligand 1<\/em>) adalah protein yang dapat digunakan sel kanker untuk mengurangi serangan sistem imun.<\/p>\n\n\n\n

Perbedaan tersebut penting karena hasil ALK dan PD-L1 dapat mengarahkan dokter keputusan terapi yang berbeda. Hasil pemeriksaan ALK positif dapat membuka pilihan terapi target, sedangkan ekspresi PD-L1 dapat membantu menilai peran imunoterapi.<\/p>\n\n\n\n

Baca juga: Kenali Mutasi EGFR dan Pentingnya pada Terapi Kanker Paru<\/a><\/p>\n\n\n\n

Mengapa Kanker Paru Perlu Diperiksa Biomarker?<\/h4>\n\n\n\n

Kanker paru, khususnya non-small cell lung cancer<\/em> (NSCLC), merupakan kelompok keganasan yang memiliki heterogenitas biologis dan molekuler yang luas. Meskipun memiliki diagnosis histopatologis yang sama, setiap pasien dapat menunjukkan karakteristik tumor, profil molekuler, perjalanan penyakit, serta respons terhadap terapi yang berbeda.<\/p>\n\n\n\n

Dalam era personalized medicine<\/em>, pemahaman terhadap heterogenitas ini menjadi landasan utama dalam penatalaksanaan NSCLC. Oleh karena itu, pendekatan diagnostik dan terapeutik tidak lagi hanya didasarkan pada klasifikasi histopatologi, tetapi juga pada karakteristik molekuler dan biomarker spesifik tumor pada setiap pasien.<\/p>\n\n\n\n

Dua dekade lalu, tata laksana kanker paru sebagian besar bertumpu pada kemoterapi dengan regimen yang relatif serupa bagi pasien dengan diagnosis histologis yang sama. Kini, memasuki era personalized medicine<\/em>, pendekatan tersebut telah bergeser secara fundamental. Penentuan terapi tidak lagi semata-mata didasarkan pada jenis dan stadium kanker, tetapi juga pada karakteristik biologis dan profil molekuler tumor setiap pasien. Pemeriksaan jaringan tumor, yang dilengkapi imunohistokimia dan pengujian biomarker molekuler, menjadi landasan penting untuk mengidentifikasi target terapeutik dan menentukan strategi pengobatan yang lebih presisi, efektif, dan sesuai dengan karakteristik individual tumor.<\/p>\n\n\n\n

ALK pada Kanker Paru<\/h4>\n\n\n\n

ALK adalah gen yang berperan dalam perkembangan sistem saraf dan jaringan tubuh selama masa pertumbuhan. Pada sebagian kecil pasien kanker paru, gen ALK mengalami penyusunan ulang (rearrangement<\/em>) sehingga bergabung dengan gen lain, paling sering EML4. Perubahan ini menghasilkan gen fusi EML4-ALK, yang memproduksi protein abnormal dengan aktivitas terus-menerus. Akibatnya, sinyal pertumbuhan sel tetap aktif, mendorong sel kanker untuk terus tumbuh dan berkembang.<\/p>\n\n\n\n

Baca juga: DNA dan Diagnosis Kanker<\/a><\/p>\n\n\n\n

Apa Itu PD-L1 pada Kanker Paru?<\/h4>\n\n\n\n

PD-L1 berbeda dari ALK. Jika kelainan ALK dapat mendorong pertumbuhan sel kanker secara terus-menerus, PD-L1 berperan dalam mekanisme yang digunakan sel kanker untuk menghindari pengenalan dan serangan sistem imun.<\/p>\n\n\n\n

Dalam kondisi normal, sel T sebagai bagian dari sistem imun memiliki reseptor PD-1 yang berfungsi sebagai rem alami untuk mencegah respons imun berlebihan dan melindungi jaringan tubuh yang sehat. Namun, ketika PD-L1 pada sel kanker berikatan dengan PD-1 pada sel T, sinyal penghambatan akan dikirimkan sehingga aktivitas sel T melemah. Akibatnya, sel kanker dapat menghindari serangan sistem imun dan terus bertahan hidup.<\/p>\n\n\n\n

Sel kanker paru dapat memanfaatkan mekanisme perlindungan alami tubuh untuk menghindari serangan sistem imun. Salah satu caranya adalah dengan memproduksi protein PD-L1 pada permukaannya. Ketika PD-L1 berikatan dengan reseptor PD-1 pada sel T, aktivitas antitumor sel T dapat ditekan. Akibatnya, kemampuan sistem imun untuk mengenali dan menghancurkan sel kanker berkurang, sehingga sel kanker memiliki peluang lebih besar untuk bertahan hidup dan terus berkembang.<\/p>\n\n\n\n

Baca juga: Tes Genomik untuk Penanganan Kanker<\/a><\/p>\n\n\n\n

Pemeriksaan ALK dan PD-L1<\/h4>\n\n\n\n
    \n
  • Imunohistokimia (IHK)<\/strong>
    Pemeriksaan imunohistokimia (IHK) merupakan teknik pemeriksaan jaringan yang menggunakan antibodi spesifik untuk mengenali protein target, seperti ALK dan PD-L1. Ikatan antara antibodi dan protein target kemudian divisualisasikan melalui reaksi pewarnaan sehingga ekspresi protein tersebut dapat dinilai di bawah mikroskop. Imunohistokimia (IHK) adalah teknik pemeriksaan jaringan menggunakan antibodi khusus yang akan “menempel” pada protein target, dalam hal ini PD-L1 dan ALK, lalu diberi pewarnaan agar dapat dilihat di bawah mikroskop.<\/li>\n\n\n\n
  • FISH (Fluorescence In Situ Hybridization<\/em>)<\/strong>
    Selain IHK, pemeriksaan FISH (Fluorescence In Situ Hybridization<\/em>) dapat digunakan untuk mengonfirmasi penyusunan ulang (rearrangement<\/em>) gen ALK secara langsung pada tingkat DNA di dalam sel tumor. FISH merupakan salah satu metode yang telah lama digunakan untuk mendeteksi ALK rearrangement<\/em> pada kanker paru jenis non-small cell lung cancer<\/em> (NSCLC). Pemeriksaan molekuler berbasis PCR atau sequencing<\/em> digunakan untuk mendeteksi fusi gen ALK dan mengonfirmasi hasil pemeriksaan sebelumnya bila diperlukan.<\/li>\n<\/ul>\n\n\n\n

    Dampak Hasil Tes terhadap Pilihan Terapi<\/h4>\n\n\n\n
      \n
    • Pasien dengan hasil ALK positif<\/strong>
      Memiliki opsi terapi target menggunakan obat golongan ALK inhibitor<\/em>. Obat golongan ini bekerja dengan menghambat protein abnormal hasil gabungan EML4-ALK, sehingga sinyal pertumbuhan sel yang awalnya “menyala terus” dapat ditekan secara spesifik. Pada banyak kasus, pasien dengan ALK positif menunjukkan respons yang baik terhadap terapi target ini dan seringkali dengan efek samping lebih dapat dikelola dibandingkan kemoterapi konvensional.<\/li>\n\n\n\n
    • Pasien dengan ekspresi PD-L1 tinggi<\/strong>
      Ditunjukkan oleh Tumor Proportion Score<\/em> (TPS) \u226550%, memiliki peluang lebih besar untuk memperoleh manfaat dari imunoterapi, khususnya pada kanker paru jenis non-small cell lung cancer<\/em> (NSCLC). Terapi ini menggunakan obat golongan immune checkpoint inhibitors<\/em>, seperti penghambat PD-1 atau PD-L1, untuk memulihkan kemampuan sistem imun dalam mengenali dan menyerang sel kanker.<\/li>\n<\/ul>\n\n\n\n

      Namun, pemilihan terapi tetap mempertimbangkan jenis histopatologi, stadium penyakit, hasil biomarker molekuler lain, serta kondisi klinis pasien. ALK dan PD-L1 adalah dua biomarker dengan cerita biologis berbeda, dan sama pentingnya dalam menentukan arah pengobatan kanker paru.<\/p>\n\n\n\n

      ALK berkaitan dengan kelainan pertumbuhan sel yang bisa ditargetkan langsung oleh terapi target, sementara PD-L1 berkaitan dengan cara sel kanker menghindari sistem imun, yang dapat dilawan melalui imunoterapi.<\/p>\n\n\n\n

      \n

      Disclaimer<\/strong>
      Informasi ini bertujuan edukasi dan tidak menggantikan konsultasi langsung dengan tenaga medis profesional. Jika Anda memiliki gejala yang mengkhawatirkan, segera konsultasikan ke dokter.<\/p>\n<\/div><\/div>\n\n\n\n

      <\/p>\n","protected":false},"excerpt":{"rendered":"

      ALK dan PD-L1 adalah dua biomarker dengan cerita biologis berbeda, dan sama pentingnya dalam menentukan arah pengobatan kanker paru.<\/p>\n","protected":false},"author":35,"featured_media":7591,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_zengeo_excluded":false,"_zengeo_faq":[],"_zengeo_takeaways":[],"footnotes":""},"categories":[1],"tags":[],"class_list":["post-7590","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"\nALK dan PD-L1 pada Kanker Paru: Dua Biomarker, Dua Peran Berbeda -<\/title>\n<meta name=\"description\" content=\"Pahami ALK PD-L1 kanker paru, perbedaan tes DNA dan IHK, arti hasil positif, serta pengaruhnya terhadap terapi. 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