Lorlatinib Demonstrates “Fantastic” PFS Results in Advanced ALK+ NSCLC

In a conversation with CancerNetwork®, Misako Nagasaka, MD, PhD, discussed the “fantastic” results associated with the 5-year progression-free survival (PFS) analysis of the phase 3 CROWN study (NCT03052608), which investigators presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting. Investigators of the CROWN trial highlighted that lorlatinib (Lorbrena) reduced the risk of disease progression or death vs crizotinib (Xalkori) among patients with advanced non–small cell lung cancer (NSCLC) harboring ALK-positive disease (HR, 0.19; 95% CI, 0.13-0.27).

According to Nagasaka, an associate clinical professor of medicine in the Division of Hematology and Oncology at UCI School of Medicine of UCI Health, the outcomes achieved with lorlatinib in the CROWN trial are not typically observed in solid tumors.

Transcript:

The CROWN study was a global phase 3 study where patients were treated [in the] first line for ALK-positive non–small cell lung cancer, and they were randomly [assigned] to either receive lorlatinib or crizotinib. Recently, the 5-year update of CROWN was presented at ASCO [in 2024], and it was a fantastic report of how long of a progression-free survival we might be able to reach.

As many [people] know, the primary end point of this study was the progression-free survival, and the 5-year report was reported [in 2024] and the lorlatinib arm hadn’t met the median progression-free survival, and the 5-year progression-free survival of those who started on lorlatinib was at 60%. This is a fantastic result that we usually never get to see in solid tumors, and it was exciting to see. It feels like, at least for some subsets of [patients with] non–small cell lung cancer, we are now able to start treating them more like [if they had] a chronic disease. It’s exciting to be in a time when this is all happening.

Reference

Solomon BJ, Liu G, Felip E, et al. Lorlatinib vs crizotinib in treatment-naïve patients with advanced ALK+ non-small cell lung cancer: 5-year progression-free survival and safety from the CROWN study. J Clin Oncol. 2024;42(suppl 17):LBA8503.