Efficacy of lorlatinib in lung carcinomas carrying distinct ALK translocation variants: The results of a single-center study.
ALK rearrangements
Brain metastases
Lorlatinib
Non-small cell lung cancer
Review
Journal
Translational oncology
ISSN: 1936-5233
Titre abrégé: Transl Oncol
Pays: United States
ID NLM: 101472619
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
03
02
2021
revised:
01
05
2021
accepted:
07
05
2021
pubmed:
25
5
2021
medline:
25
5
2021
entrez:
24
5
2021
Statut:
ppublish
Résumé
Lorlatinib is a novel potent ALK inhibitor, with only a few studies reporting the results of its clinical use. This study describes the outcomes of lorlatinib treatment for 35 non-small cell lung cancer patients with ALK rearrangements, who had 2 (n = 5), 1 (n = 26) or none (n = 4) prior tyrosine kinase inhibitors and received lorlatinib mainly within the compassionate use program. Objective tumor response (OR) and disease control (DC) were registered in 15/35 (43%) and 33/35 (94%) patients, respectively; brain metastases were particularly responsive to the treatment (OR: 22/27 (81%); DC: 27/27 (100%)). Median progression free survival (PFS) was estimated to be 21.8 months, and median overall survival (OS) approached to 70.1 months. Only 4 out of 35 patients experienced no adverse effects; two of them were the only subjects who had no clinical benefit from lorlatinib. PFS and OS in the no-adverse-events lorlatinib users were strikingly lower as compared to the remaining patients (1.1 months vs. 23.7 months and 10.5 months vs. not reached, respectively; p < 0.0001 for both comparisons). ALK translocation variants were known for 28 patients; there was no statistical difference between patients with V.1 and V.3 rearrangements with regard to the OS or PFS. Use of lorlatinib results in excellent disease outcomes, however caution must be taken for patients experiencing no adverse effects from this drug.
Sections du résumé
BACKGROUND
BACKGROUND
Lorlatinib is a novel potent ALK inhibitor, with only a few studies reporting the results of its clinical use.
METHODS
METHODS
This study describes the outcomes of lorlatinib treatment for 35 non-small cell lung cancer patients with ALK rearrangements, who had 2 (n = 5), 1 (n = 26) or none (n = 4) prior tyrosine kinase inhibitors and received lorlatinib mainly within the compassionate use program.
RESULTS
RESULTS
Objective tumor response (OR) and disease control (DC) were registered in 15/35 (43%) and 33/35 (94%) patients, respectively; brain metastases were particularly responsive to the treatment (OR: 22/27 (81%); DC: 27/27 (100%)). Median progression free survival (PFS) was estimated to be 21.8 months, and median overall survival (OS) approached to 70.1 months. Only 4 out of 35 patients experienced no adverse effects; two of them were the only subjects who had no clinical benefit from lorlatinib. PFS and OS in the no-adverse-events lorlatinib users were strikingly lower as compared to the remaining patients (1.1 months vs. 23.7 months and 10.5 months vs. not reached, respectively; p < 0.0001 for both comparisons). ALK translocation variants were known for 28 patients; there was no statistical difference between patients with V.1 and V.3 rearrangements with regard to the OS or PFS.
CONCLUSION
CONCLUSIONS
Use of lorlatinib results in excellent disease outcomes, however caution must be taken for patients experiencing no adverse effects from this drug.
Identifiants
pubmed: 34030112
pii: S1936-5233(21)00113-3
doi: 10.1016/j.tranon.2021.101121
pmc: PMC8144735
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101121Informations de copyright
Copyright © 2021. Published by Elsevier Inc.