A New Groundbreaking Drug for Lung Cancer Treatments

 

The American Cancer Society's estimates for lung cancer in the US for 2024 are: About 234,580 cases

The remarkable trial results for a new drug, lorlatinib, has proven to halt lung cancer progression longer than any other treatment so far. These findings offer hope for improved survival rates in patients with advanced lung cancer, a disease that claims about 1.8 million lives each year globally.

Unprecedented Survival Rates

The data, presented at the American Society of Clinical Oncology (ASCO) annual meeting, revealed that more than half of the patients (60%) with advanced lung cancer who took lorlatinib were still alive five years later without disease progression. This is a significant contrast to the mere 8% progression-free survival (PFS) rate observed in patients treated with the standard drug, crizotinib. These results mark the longest PFS outcomes ever recorded for patients with non-small cell lung cancer (NSCLC), the most common form of lung cancer.

Dr. Benjamin Solomon, a medical oncologist at the Peter MacCallum Cancer Centre in Melbourne, Australia, and the study’s lead author, remarked on the significance of these findings: “To our knowledge, these results are unprecedented.”

The phase 3 trial involved 296 patients with advanced NSCLC. Participants were randomly assigned to receive either lorlatinib (149 patients) or crizotinib (147 patients, with 142 ultimately receiving treatment). Just over half of the patients were women, and about 25% had cancer that had already spread to the brain at the start of the study. All participants had ALK-positive NSCLC, a specific type of lung cancer characterized by the presence of the ALK protein, which both lorlatinib and crizotinib target.

Significant Findings

Dr. Solomon explained that while advancements in ALK tyrosine kinase inhibitors (TKIs) have been made, most patients treated with second-generation ALK TKIs experience disease progression within three years. Lorlatinib, however, demonstrated a five-year PFS rate of 60%, compared to just 8% for crizotinib. This is particularly noteworthy given that disease control, including in the brain, continues beyond this period for the majority of lorlatinib patients.

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

Most patients did experience some side effects, with treatment-related issues occurring in 77% of lorlatinib patients and 57% of crizotinib patients. The most common side effects were swelling, high cholesterol, and elevated lipid levels.

Dr. David Spigel, chief scientific officer at the Sarah Cannon Research Institute in London, described the results as “off the chart,” while Cancer Research UK’s chief clinician, Prof. Charles Swanton, praised the findings as “groundbreaking.” Swanton emphasized the significance of the study in offering new hope for patients with advanced lung cancer, noting the difficulty of controlling cancers that have spread and the limited treatment options available.