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12-01-2023 | Non-small-cell lung cancer | News

News in brief

CROWN update confirms long-term lorlatinib PFS benefit

Author: Lynda Williams


medwireNews: Lorlatinib offers a “durable benefit” for the first-line treatment of advanced ALK-positive non-small-cell lung cancer (NSCLC), indicates a 3-year update from the CROWN trial.

Following on from the initial trial results showing a progression-free survival (PFS) advantage with lorlatinib versus crizotinib, the current unplanned analysis found that median PFS had not yet been reached in the lorlatinib-treated patients at 3 years after follow-up and was significantly longer than the 9.3 months achieved by patients given crizotinib (hazard ratio [HR]=0.27).

And as per an earlier post-hoc analysis, median PFS continued to be significantly better with lorlatinib than crizotinib among the subgroup of patients with baseline brain metastases (unreached vs 7.2 months; HR=0.21).

Compared with crizotinib, lorlatinib also offered better overall and intracranial response rates, a longer duration of response and a longer time to intracranial progression regardless of baseline brain metastases, report Benjamin Solomon (Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia) and co-authors in The Lancet Respiratory Medicine.

Just 1% of lorlatinib-treated patients without brain metastases at baseline had experienced intracranial progression by data cutoff versus 23% of those given crizotinib, the investigators note.

“The high intracranial response rates and the beneficial effect on time to intracranial progression provide and argument to use first-line lorlatinib to treat patients with established brain metastases and to prevent the development of new brain metastases in patients without brain metastases”, they conclude.

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Lancet Resp Med 2023; doi:10.1016/S2213-2600(22)00437-4