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The trial with the longest disease control ever seen for a targeted lung cancer pill: most patients still progression-free at five years.
296 patients. At 5 years, PFS was 60% with lorlatinib versus 8% with crizotinib (HR 0.19); median PFS not reached after >60 months of follow-up. Intracranial progression was nearly abolished (5-year cumulative incidence ~8% in patients without baseline brain metastases). Neurocognitive, mood, weight, and lipid effects require management.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
296 enrolled.
Cumulative incidence in patients without baseline brain metastases
SourceStep lines join published landmark estimates; the true curve between them is not shown.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 5 years (BICR)primary | Lorlatinib | 149 | 60% | 0.19 (0.13 to 0.27) | - | link |
| Crizotinib | 147 | 8% | ||||
| Intracranial progression at 5 years | Lorlatinib | - | 8% | - | - | link |
| Crizotinib | - | 40% |
A second publication from the CROWN trial, later than the first and described in its title as an update or longer-term analysis. Read it with the primary publication linked from the trial page; the record was linked automatically and its figures have not been checked by hand.
The current first choice for ALK-positive lung cancer in most guidelines, and the strongest evidence in solid tumour oncology that a drug can be designed to work inside the brain. Five-year follow-up has since shown the majority of patients still progression-free.
Shares D. Ross Camidge, eXalt3, ASCEND-4, PROFILE 1014.
Shares D. Ross Camidge, eXalt3, ASCEND-4, PROFILE 1014.
Shares PROFILE 1014, ALK-positive non-small-cell lung cancer, ALK, Lung cancer (all types).
Shares D. Ross Camidge, ALK-positive non-small-cell lung cancer, ALK, Small-molecule kinase inhibitors.
Shares ASCEND-4, ALK-positive non-small-cell lung cancer, ALK, Lung cancer (all types).
Shares PROFILE 1014, ALK-positive non-small-cell lung cancer, ALK, Lung cancer (all types).
Shares Lorlatinib, ALK-positive non-small-cell lung cancer, ALK, Small-molecule kinase inhibitors.
Shares D. Ross Camidge, ALK-positive non-small-cell lung cancer, ALK, Non-small-cell lung cancer.