ASCO 2024: lorlatinib yields longest ever PFS recorded for ALK+ NSCLC patients
Data from the Phase III CROWN study, evaluating the ALK TKI lorlatinib, has demonstrated the best outcomes ever observed for advanced NSCLC patients.
The CROWN study included 296 individuals with advanced, previously untreated ALK+ NSCLC who were randomly assigned to receive either lorlatinib (149 patients) or crizotinib (147 patients). Lorlatinib resulted in longer progression-free survival (PFS) and better control and prevention of brain metastases compared to those treated with crizotinib. The data was recently presented at the 2024 ASCO Annual Meeting (May 31–June 4, IL, USA).
The 5-year PFS was 60% in the lorlatinib group and 8% in the crizotinib group. Median PFS has not yet been reached for lorlatinib, corresponding to the longest PFS ever reported for this cohort, median PFS was 9.1 months in the crizotinib group.
“Despite significant advancements with newer generation ALK TKIs, the majority of patients treated with second-generation ALK TKIs will have progression of their disease within 3 years. Lorlatinib is the only ALK TKI that has reported 5-year PFS, and even after this time, the majority of patients continue to have their disease controlled, including control of disease in the brain,” commented lead study author Benjamin Solomon (Peter MacCallum Cancer Center, Melbourne, Australia).
“To our knowledge these results are unprecedented for any TKI in patients with metastatic NSCLC,” Solomon added.
“These long-term data results are off the chart and this study confirms the outstanding durable efficacy of lorlatinib as a first-line choice for patients with ALK-positive NSCLC. However, it will be important to compare this treatment option to more commonly used ALK TKIs than crizotinib. Still, these findings report some of the best outcomes ever observed for an ALK TKI,” commented ASCO spokesperson David R Spigel (Sarah Cannon Research Institute, TN, USA).
Plain language summary of updated results from the CROWN study
Read a Plain language summary of the 3-year mark results from the CROWN study.
As the median PFS has yet to be reached for lorlatinib, next steps for the trial involve the long-term follow up of patients.