medwireNews: Analysis of data from the pivotal phase 2 trial of lorlatinib points to the benefit of continuing treatment with the third-generation ALK inhibitor beyond progression in some patients with advanced non-small-cell lung cancer (NSCLC) positive for ALK translocations.
The researchers identified 102 patients who achieved a complete response, partial response, or stable disease for at least 6 weeks in response to treatment with lorlatinib 100 mg/day before experiencing disease progression as defined by RECIST criteria. Of these, 28 had previously received crizotinib as the only ALK inhibitor (group A), while the remaining 74 had received one or more second-generation ALK inhibitors (group B).
In group A, median overall survival (OS) was not reached for the 21 patients who continued lorlatinib beyond progression at the investigator’s discretion and was 24.4 months for the seven who did not, report Sai-Hong Ou (University of California Irvine, USA) and co-researchers in the Journal of Thoracic Oncology.
The median OS durations in group B were 26.5 months for the 56 participants who received lorlatinib beyond progression and 14.7 months for the 18 patients who did not.
The authors caution that the small number of participants who discontinued lorlatinib at progression in group A “does not allow definitive conclusions to be drawn in that group.”
They nevertheless believe that continuing lorlatinib beyond progression “is a viable treatment option for select patients with ALK-positive NSCLC,” especially as the OS prolongation did not come at the cost of quality of life as assessed by global EORTC QLQ-C30 score.
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