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TRIAL RESULTS FOR NEW LUNG CANCER DRUG ARE ‘OFF THE CHARTS’, SAY
DOCTORS  
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Andrew Gregory
May 31, 2024
The Guardian
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_ More than half of patients with advanced forms of disease who took
lorlatinib were still alive after five years with no progression _

Lung cancer is the world’s leading cause of cancer death,
accounting for about 1.8m deaths every year., da-kuk/Getty Images

 

Lung cancer is the world’s leading cause of cancer death, accounting
for about 1.8m deaths every year.,da-kuk/Getty Images
Doctors are hailing “off the chart” trial results that show a new
drug stopped lung cancer advancing for longer than any other treatment
in medical history.

Lung cancer is the world’s leading cause of cancer death, accounting
for about 1.8m deaths every year. Survival rates in those with
advanced forms of the disease, where tumours have spread, are
particularly poor.

More than half of patients (60%) diagnosed with advanced forms of lung
cancer who took lorlatinib were still alive five years later with no
progression in their disease, data presented at the world’s largest
cancer conference showed. The rate was 8% in patients treated with a
standard drug, the trial found.

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The results are the longest progression-free survival (PFS) outcomes
ever recorded in patients with non-small cell lung cancer, the
world’s most common form of the disease. They were presented at the
annual meeting of the American Society of Clinical Oncology (Asco) in
Chicago on Friday.

“To our knowledge these results are unprecedented,” said the
study’s lead author, Dr Benjamin Solomon, a medical oncologist at
the Peter MacCallum Cancer Centre in Melbourne, Australia.

In the phase 3 trial, 296 patients with advanced forms of non-small
cell lung cancer were randomly assigned to receive either lorlatinib
(149 patients) or crizotinib (147 patients, of whom 142 ultimately
received treatment).

Just over half of the patients were women. In about 25% of them their
lung cancer had already spread to the brain when the study began.

The participants all had ALK-positive non-small cell lung cancer.
Lorlatinib and crizotinib are both ALK tyrosine kinase inhibitors
(TKIs). ALK TKIs are targeted treatments that bind to the ALK protein
found in ALK-positive non-small cell lung cancer and stop the growth
of tumour cells.

“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 three years,” said Solomon.

“Lorlatinib is the only ALK TKI that has reported five-year
progression-free survival, and even after this time, the majority of
patients continue to have their disease controlled, including control
of disease in the brain.”

The five-year progression-free survival (PFS) rate was 60% in patients
who took lorlatinib and 8% in the crizotinib group.

“You don’t need a magnifying glass to see the difference between
these two drugs,” said Dr Julie Gralow, Asco’s chief medical
officer. “Sixty per cent five-year progression-free survival in
non-small cell lung cancer is just unheard of.”

Dr David Spigel, the chief scientific officer of the Sarah Cannon
Research Institute in London, a world-leading clinical trials facility
specialising in new therapies for cancer patients, welcomed the
findings. “These long-term data results are off the chart,” he
said.

Most of the patients experienced some side-effects. Treatment-related
issues occurred in 77% of patients on lorlatinib and in 57% of
patients on crizotinib. The most common side-effects reported in the
trial that was funded by Pfizer were swelling, high cholesterol and
elevated lipid levels.

Cancer Research UK’s chief clinician, Prof Charles Swanton, who was
not involved with the study, said the “groundbreaking” results
would offer fresh hope for patients with advanced lung cancer.

“Despite progress in our understanding of the disease, it can be
incredibly challenging to control cancers that have spread and there
are limited treatment options for lung cancer,” he said.

“Showcasing the power of cancer-growth blocker drugs, this study
could present us with an effective way of stopping cancer in its
tracks and preventing it from spreading to the brain.

“The groundbreaking results show that over half of the patients who
took lorlatinib did not suffer a progression in their disease after
five years. In contrast, over half of the patients who took crizotinib
experienced disease progression after just nine months.

“Research like this is vital to find new ways to treat lung cancer
and help more people survive for longer.”

_MODERATOR: SEE ALSO FROM WORLD'S LARGEST CANCER CONFERENCE, THIS PAST
WEEK IN CHICAGO_

_Drug That ‘Melts Away’ Tumours Could Replace Surgery for Bowel
Cancer, Say Doctors
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by Andrew Gregory
All patients in pembrolizumab trial were found to be cancer-free after
combination of drug and surgery
The Guardian
June 2, 2024_

_ANDREW GREGORY is the Guardian's health editor. Twitter
@andrewgregory. Click here for his public key_

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