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An International Real-World Analysis of the Efficacy and Safety of Lorlatinib Through Early or Expanded Access Programs in Patients With Tyrosine Kinase Inhibitor-Refractory ALK-Positive or ROS1-Positive NSCLC

Cited 8 time in Web of Science Cited 8 time in Scopus
Authors
Zhu, Viola W.; Lin, Yen-Ting; Kim, Dong-Wan; Loong, Herbert H.; Nagasaka, Misako; To, Hao; Ang, Yvonne Li-En; Ock, Chan-Young; Tchekmedyian, Nishan; Ou, Sai-Hong Ignatius; Syn, Nicholas L.; Reungwetwattana, Thanyanan; Lin, Chia-Chi; Soo, Ross A.
Issue Date
2020-09
Citation
Journal of Thoracic Oncology, Vol.15 No.9, pp.1484-1496
Keywords
LorlatinibExpanded accessTKI-refractoryALKROS1NSCLC
Abstract
Introduction: Lorlatinib, a next-generation central nervous system-penetrant ALK/ROS1 tyrosine kinase inhibitor (TKI), is approved to treat TKI-refractory ALK-positive (ALK+) NSCLC based on results from a phase 2 study. Methods: A real-world analysis was performed on ALK+ or ROS1-positive (ROS1+) patients with NSCLC enrolled in lorlatinib early or expanded access programs in Hong Kong, Singapore, South Korea, Taiwan, Thailand, and the United States. Results: A total of 95 patients with NSCLC (76 ALK+ and 19 ROS1+) were analyzed. Among ALK+ patients treated with less than two previous TKIs, two or more previous TKIs, and three or more previous TKIs, the objective response rates (ORR) and median progression-free survival (mPFS) were 42% (95% confidence interval [CI]: 26-59; n = 38) and not reached (NR) (95% CI: 4.5-NR; n = 45), 35% (95% CI: 22-49; n = 55) and 11.2 months (95% CI: 4.5-NR; n = 66), and 18% (95% CI: 4-43; n = 17) and 6.5 months (95% CI: 3.5-11.6; n = 21), respectively. The ORRs and mPFSs were 13% (95% CI: 0-53; n = 8) and 9.2 months (95% CI: 3.3-NR; n = 9) for patients treated with one second generation ALK TKI as the only ALK TKI received. For ROS1+ patients, ORRs and mPFSs were 41% (95% CI: 18- 67; n = 17) and 11.9 months (95% CI: 6.4-NR; n = 19). The intracranial ORRs were 35% (95% CI: 22-49) and 55% (95% CI: 23-83) for 52 ALK+ and 11 ROS1+ patients. mPFS was 9.3 months (95% CI: 1.0-NR; n = 13) for patients with leptomeningeal carcinomatosis. No new safety signals were noted. Conclusion: Lorlatinib exhibited meaningful activity in TKIrefractory ALK+ or ROS1+ patients with NSCLC enrolled in early or expanded access programs.
ISSN
1556-0864
URI
https://hdl.handle.net/10371/171813
DOI
https://doi.org/10.1016/j.jtho.2020.04.019
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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