WCLC 2020: Patient-Reported Outcomes With Lorlatinib Versus Crizotinib in ALK-Positive NSCLC
Posted: Friday, February 12, 2021
According to Julien Mazieres, MD, PhD, of Toulouse University Hospital, France, and colleagues, in the phase III CROWN trial, the third-generation ALK inhibitor lorlatinib seemed to significantly improve progression-free survival compared with crizotinib in patients with untreated advanced ALK-positive non–small cell lung cancer (NSCLC). The patient-reported outcomes, which were presented in January 2021 during the virtual edition of the International Association for the Study of Lung Cancer (IASLC) 2020 World Conference on Lung Cancer Singapore (WCLC; Abstract MA11.08), support previous results.
“The time to treatment deterioration for lung cancer symptoms was comparable between treatment arms,” Dr. Mazieres reported in an IASLC press release. “Improvements in lung cancer symptoms were seen early, and clinically meaningful improvements in cough were detected in [patients who received] lorlatinib.”
A total of 296 patients were randomly assigned to receive lorlatinib or crizotinib. There did not appear to be any clinically meaningful or statistically significant differences between the treatment arms in any functioning domain. Numerical improvements in physical, role, emotional, and social functioning scales were reported with lorlatinib; cognitive functioning seemed to improve with crizotinib. Lorlatinib appeared to significantly improve symptoms of fatigue, nausea and vomiting, insomnia, appetite loss, and constipation compared with crizotinib; however, the differences between the treatment arms were not clinically meaningful. For diarrhea, there seemed to be a clinically meaningful and statistically significant difference favoring lorlatinib.
In both treatment arms, clinically meaningful improvements in cough were reported as early as cycle 2 and maintained through cycle 18. The times to treatment deterioration in cough, dyspnea, and pain in the chest were similar between the treatment arms (hazard ratio = 1.09; P = .5415). The median time to worsening of global quality of life was longer with lorlatinib than with crizotinib (24.0 vs. 12.0 months; hazard ratio = 0.92).
Disclosure: For full disclosures of the study authors, visit wclc2020.iaslc.org.
