Safety of Lorlatinib in Patients with Unresectable Advanced <i>ALK</i>-Positive Non-Small-Cell Lung Cancer Previously Treated with ALK Inhibitors: A Single-Arm, Open-Label, Phase IV Study in India

Lorlatinib is approved in India for patients with previously treated anaplastic lymphoma kinase (ALK)–positive advanced or recurrent non-small-cell lung cancer (NSCLC). Owing to the limited number of Indian patients in phase I/II and III studies, a postapproval study was conducted to report the safe...

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Main Authors: Ullas Batra, Vineet G. Gupta, Nirmal Raut, Tushar Patil, Harsha Panchal, Nikhil Ghadyalpatil, Anand Pathak, Chirag Desai, Shailesh Bondarde, Minish Jain, Christian Russel Reyes, Shyam Parvatini, Seema Pai, Francesca Toffalorio, Holger Thurm, Bivas Biswas
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2025-08-01
Series:Indian Journal of Medical and Paediatric Oncology
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1801883
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Summary:Lorlatinib is approved in India for patients with previously treated anaplastic lymphoma kinase (ALK)–positive advanced or recurrent non-small-cell lung cancer (NSCLC). Owing to the limited number of Indian patients in phase I/II and III studies, a postapproval study was conducted to report the safety and efficacy of lorlatinib in this patient population. In this phase IV study, patients with unresectable advanced and/or recurrent ALK-positive NSCLC resistant or intolerant to ≥1 prior ALK inhibitor were treated with lorlatinib. The primary endpoint was investigator-assessed incidence of treatment-related adverse events (TRAEs). Secondary endpoints were investigator-assessed objective response rate (ORR), intracranial ORR, duration of response (DOR), and intracranial DOR. Among the 100 patients enrolled, the most frequently reported TRAEs were hypertriglyceridemia (57%), hypercholesterolemia (57%), and weight increase (38%). The confirmed ORR and intracranial ORR by the investigator were 41% (95% confidence interval [CI]: 31.9–50.8%) and 36% (95% CI: 24.5–48.8%), respectively. The median systemic and intracranial DORs were not reached. The safety profile of lorlatinib was consistent with that reported in the phase I/II study. Lorlatinib showed a clinically meaningful improvement in ORR and intracranial ORR in patients with unresectable advanced ALK-positive NSCLC. These results support the use of lorlatinib in India for patients with previously treated ALK-positive advanced NSCLC.
ISSN:0971-5851
0975-2129