WCLC 2018: Lorlatinib Active in ROS1-Positive NSCLC
Posted: Thursday, October 11, 2018
Results from an ongoing study showed that lorlatinib treatment in patients with advanced ROS1-positive non–small cell lung carcinoma (NSCLC) may lead to “rapid and durable” responses. Although activity with this third-generation ALK/ROS1 tyrosine kinase inhibitor was observed in both patients who had and had not received prior crizotinib treatment, more than twice as many patients who were crizotinib-naive responded to lorlatinib. Alice T. Shaw, MD, PhD, of Massachusetts General Hospital, presented these phase II study findings at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) in Toronto (Abstract OA02.03).
At data cutoff (February 2018), 47 patients with ROS1-positive advanced NSCLC with or without baseline central nervous system (CNS) metastasis, comprising both crizotinib-naive (n = 13) and crizotinib-treated (n = 34) patients, received lorlatinib. The objective response rate in all cohorts was 36.2%. However, more patients who had not received crizotinib responded compared with those who had already received crizotinib (61.5% vs. 26.5%). The response lasted at least 12 months for 10 patients (5 of whom were crizotinib-naive, and 5 of whom had previously been exposed to crizotinib). For the 25 patients with CNS metastasis, the objective intracranial response rate in all cohorts was 56%, with a duration of response lasting at least 12 months for 5 patients (4 of whom were previously exposed to crizotinib).
Common treatment-related adverse events were hypercholesterolemia (83%) and hypertriglyceridemia (60%). The authors noted that the safety profile of lorlatinib was similar to that previously reported in the ALK/ROS1 patient population.
