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

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CROWN update confirms long-term lorlatinib PFS benefit

Author: Lynda Williams

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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.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2023 Springer Healthcare Ltd, part of the Springer Nature Group

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

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