Patients with an incurable form of lung cancer can lead normal lives by taking a daily pill that “stops the cancer in its tracks”, a new study has found.
Scientists have hailed the drug, called lorlatinib, for its “off the charts” results after a trial found it improved survival rates for the longest period ever recorded.
In the trial, lorlatinib stopped the cancer from spreading for at least five years in 60 percent of patients, including just over half of the participants whose cancer had already spread to the brain before the trial began.
It has been so effective that at the time of publishing the results, the researchers were unable to give an average number of months that patients were able to live without their cancer getting worse, because most are still living without progression.
Experts said it was the “longest progression-free survival ever reported” for a lung cancer treatment.
The drug significantly outperformed the 8 percent who were progression-free at five years in a control group receiving an alternative treatment called crizotinib, with the cancer spreading after an average of 9.1 months.
Dr David Spigel, chief scientific officer at the Sarah Cannon Research Institute and a member of the American Society of Clinical Oncology (ASCO), said the industry had “not seen anything close to this”.
“The results with lorlatinib are the best we’ve ever seen,” he added.
“We just haven’t seen results like this in oncology that often, much less in non-small cell lung cancer. These are among the best results we’ve seen in advanced disease in any setting…a really big step forward in lung cancer care.”
“May prevent spread in the brain”
The treatment is for a deadly subtype of lung cancer that is more common in young, non-smokers who have a specific mutation of the anaplastic lymphoma kinase (ALK) gene.
It is often diagnosed at a later stage when it is more difficult to treat and accounts for around five percent of non-small cell lung cancers (NSCLC) – the most common form – affecting around 350 patients each year.
Around 49,000 people are diagnosed with lung cancer in the UK each year.
The drug works by binding to a protein in tumor cells and stopping it from growing and spreading.
Professor Charles Swanton, chief clinician at Cancer Research UK, said the study “may provide us with an effective way to stop cancer in its tracks and prevent it from spreading to the brain”.
“Research like this is vital to finding new ways to treat lung cancer and help more people survive longer.”
It is available on the NHS on a limited basis for patients who have not had success with other treatments, but is only given to around 80 patients a year. The pill costs around £167 a day based on its list price.
It was rejected for wider use last year by the spending watchdog, the National Institute for Health and Care Excellence (NICE), due to a lack of evidence, but could soon be reconsidered in the light of new data.
“Unprecedented results for patients”
Benjamin Solomon, lead author and head of medical lung oncology at the Peter MacCallum Cancer Centre, Melbourne, Australia, said: “The progression-free survival benefit observed with lorlatinib in this five-year analysis corresponds to the longest progression-free survival ever. reported in ALK+ non-small cell lung cancer, and indeed, to our knowledge, for any targeted therapy in lung cancer to date, and speaks to the progress made in this field.”
He said the findings, which are being presented at the ASCO conference today, “show that this provides an unprecedented improvement in patient outcomes.”
The research team divided 296 patients with the ALK mutation into groups and gave half of them lorlatinib and half of them crizotinib.
Lorlatinib was also more effective at stopping the disease in the quarter of participants whose cancer had spread to the brain before the trial began, with 53 percent living for five years without the disease getting worse, compared with a negligible amount in the control group. control.
All patients had brain scans at study entry and every eight weeks. Lorlatinib prevented the progression of existing cancer that had spread to the brain and prevented or delayed the progression of new metastases.
Dr Julie Gralow, chief medical officer at ASCO said: “You don’t need a magnifying glass to see the difference between these two drugs. It’s just a profound difference… 60 percent five-year progression-free survival in non-small cell lung cancer is just unheard of.”
Debra Montague, Chair of ALK Positive Lung Cancer UK, said: “Lung cancer often spreads to the brain and Lorlatinib is very successful in stopping this. The drug is not yet in use for first-line treatment in England, but hopefully after these results, it will receive approval.”
