First-line lorlatinib for advanced ALK-positive non-small-cell lung cancer
Mené dans 23 pays sur 425 patients atteints d'un cancer du poumon non à petites cellules ALK+ de stade avancé, cet essai de phase III compare l'efficacité, du point de vue de la survie sans progression, et la toxicité du lorlatinib et du crizotinib en traitement de première ligne
The treatment framework for advanced non-small-cell lung cancer harbouring anaplastic lymphoma kinase (ALK) fusions has changed substantially since the discovery of crizotinib, a first-generation ALK tyrosine-kinase inhibitor (TKI). Three generations of ALK TKIs have since been developed, with increasing potency, CNS penetrance, and ability to overcome ALK-resistance mutations with each successive generation. 1 Multiple phase 3 trials have shown superior efficacy of second-generation ALK TKIs (alectinib, brigatinib, and ensartinib) compared with crizotinib, establishing next-generation ALK TKIs as preferred initial therapy. 1 More recently, interim analysis of the phase 3 trial CROWN showed favourable efficacy of first-line lorlatinib, a third-generation ALK TKI, compared with crizotinib. 2 With this rich therapeutic landscape, clinicians now face the key question of which next-generation ALK TKI to select.
The Lancet Respiratory Medicine , commentaire, 2021