Early treatment with lorlatinib improves survival in some lung cancer patients
BOSTON - Lung cancer patients with a specific genetic alteration lived longer and were protected against metastasis to the brain when treated early with the drug lorlatinib (Lorbrena), according to a study led by researchers at Massachusetts General Hospital (MGH), published in the New England Journal of Medicine (NEJM).
Lorlatinib (Pfizer) is a novel third-generation ALK inhibitor that is more potent than second-generation inhibitors in biochemical and cellular assays and has the broadest coverage of ALK resistance mutations that have been identified.
Non-small-cell lung cancer (NSCLC) accounts for 87% of all cases of lung cancer. Some 5% of NSCLC cases are ALK-positive, which means they have a genetic abnormality in the anaplastic lymphoma kinase gene. ALK-positive NSCLC, which is not associated with smoking, is a particularly aggressive form of lung cancer.
"When ALK is turned on abnormally, it's like stepping on the gas pedal--it drives uncontrolled proliferation and survival of cancer cells," says investigator Alice Shaw, MD, PhD, who was formerly director of the Center for Thoracic Cancers at MGH and led the NEJM study. Notably, ALK-positive patients tend to be 10 to 15 years younger than other lung cancer patients. They are also at high risk for developing brain metastasis.
https://www.nejm.org/doi/10.1056/NEJMoa2027187
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