Can lorlatinib/lorlatinib cure lung cancer?

Lung cancer patients with specific genetic changes lived longer and did not metastasize to the brain when treated early with the drug lorlatinib. Non-small cell lung cancer (NSCLC) accounts for 87% of all lung cancer cases. About 5% of NSCLC cases are ALK-positive, meaning they have a genetic abnormality in the anaplastic lymphoma kinase gene. ALK-positive non-small cell lung cancer has nothing to do with smoking and is a particularly aggressive form of lung cancer.

Lorlatinib belongs to the third generation of this drug and is even more effective at blocking ALK. It is currently approved by the Food and Drug Administration to treat ALK-positive patients whose cancer has progressed despite taking older generation ALK inhibitors. To study whether lorlatinib, when used as first-line treatment, could improve the likelihood of long-term remission in ALK-positive patients, 296 patients with advanced, untreated ALK-positive non-small cell lung cancer were recruited. Half of the patients were treated with lorlatinib and the remainder with crizotinib, which was the standard treatment for these patients at the start of the trial.

The results are stunning. Compared with patients who received crizotinib, patients who received lorlatinib had a 72% lower risk of cancer progression or death. Importantly, lorlatinib also reduced the risk of new or recurrent brain metastases by 93%. Serious side effects were more common in the lorlatinib group, but more than half were increased blood cholesterol and triglycerides, which can be controlled with the drug.

To be clear, however, lorlatinib does not cure lung cancer. Although it can delay the growth and spread of tumors and reduce related symptoms, it cannot completely cure lung cancer. In addition to drug treatment, radiotherapy, surgery, and chemotherapy are also common methods for lung cancer treatment. For different stages and types of lung cancer, doctors will develop individualized treatment plans based on the patient's specific conditions.