Comparing First Line Treatment Of ALK Positive Lung Cancer

In the treatment of ALK positive non small cell lung cancer (NSCLC), first line agents lorlatinib and crizotinib showed no clinically meaningful or statistically significant differences.

A phase III CROWN study’s patient-reported outcomes showed that the time to treatment deterioration (TTD) in chest pain, shortness of breath, and cough was comparable between those who received lorlatinib and patients who took crizotinib.

The study was presented at the International Association for the Study of Lung Cancer's 2020 World Conference on Lung Cancer Singapore.

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‘According to a phase III CROWN study’s, first line agents lorlatinib and crizotinib in the treatment of ALK positive non small cell lung cancer (NSCLC) showed no clinically meaningful or statistically significant differences.’
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Lorlatinib is a third generation ALK inhibitor that has significantly improved progression-free survival when compared to crizotinib in patients with previously untreated advanced ALK-positive NSCLC.

The detailed result of patient reported outcomes (PROs) was presented by Dr. Julien Mazieres, Toulouse University Hospital, in Toulouse, France.

296 patients with ALK positive NSCLC were enrolled in the trial and were randomly assigned to receive either lorlatinib or crizotinib. The PROs were assessed by using EORTC QLQ-C30 and QLQ-LC13, and the EQ-5D-5L assessments in order to rate the health-related quality of life (QOL) of patients with cancer participating in international clinical trials. All the patients completed on the first day of each cycle (28 days) through end of treatment.

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The team measured the time to treatment deterioration (TTD) in pain in chest, dyspnea, and cough and compared these results between the two treatment arms. There was no clinically meaningful or statistically significant differences between treatment arms.

However, for diarrhea both a clinically meaningful and statistically significant difference favoring lorlatinib were seen.

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In both the treatments arms, lung cancer symptoms improved from baseline with clinically meaningful improvements in cough as early as Cycle 2 and maintained through Cycle 18.

Dr Mazieres said, “Time to treatment deterioration for lung cancer symptoms was comparable between treatment arms. Improvements in lung cancer symptoms were seen early and clinically meaningful improvements in cough were detected in [patients who received] lorlatinib. Patient-reported outcomes in phase III CROWN support the improved PFS and are consistent with safety/tolerability of lorlatinib relative to crizotinib.”

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Source-Medindia