Effects and limitations of lorlatinib/lorlatinib in the treatment of lung cancer

For lung cancer patients carrying specific genetic mutations, early treatment with lorlatinib/Lorlatinib can significantly extend survival and effectively reduce the risk of cancer metastasis to the brain. Non-small cell lung cancer (NSCLC) accounts for 87% of all lung cancer cases, and about 5% of these cases are ALK-positive, which means there is an abnormality in the anaplastic lymphoma kinase gene. This type of ALK-positive non-small cell lung cancer is not directly related to smoking behavior, but it is extremely aggressive.

Lorlatinib, as a third-generationALK inhibitor, has shown higher efficiency in blocking ALK. It is currently approved by the Food and Drug Administration for the treatment of ALK-positive patients whose disease has progressed despite older-generation ALK inhibitors. In order to explore whether lorlatinib as a first-line treatment drug can improve the long-term response rate of ALK-positive patients, a study included 296 patients with advanced, untreated ALK-positive non-small cell lung cancer. Of these patients, half received lorlatinib and the other half received crizotinib, which was the standard treatment at the start of the study.

The results are impressive. Compared with patients who received crizotinib, patients who received lorlatinib had up to a 72% lower risk of cancer progression or death. What's more worth mentioning is that lorlatinib also significantly reduced the risk of new or recurrent brain metastases by 93%. Although the incidence of serious side effects was higher in the lorlatinib group, more than half of the side effects were increases in blood cholesterol and triglycerides, which can be effectively controlled by the drug.