By Kate Pickles Chicago Health Editor
13:01 31 May 2024, updated 15:29 31 May 2024
Patients with incurable lung cancer could have their lives extended by several years by a drug hailed as the “best ever” treatment for the disease.
About six in ten patients given a daily tablet treated with lorlatinib survived five years without their cancer progressing, compared with just eight percent receiving standard care.
Scientists said the results were “off the charts” after a study found it improved survival rates for the longest time ever recorded.
Researchers presenting the findings at the American Society of Clinical Oncology conference in Chicago said it was impossible to say how long it extended life because the majority were still living without progression.
The study included 296 people with advanced non-small cell lung cancer caused by a mutation in the ALK gene, an aggressive form of the disease that often spreads to the brain.
Usually non-smokers who are younger than the average lung cancer patient, around 350 people in the UK are diagnosed each year with ALK-positive lung cancer.
Experts hope that lorlatinib will be approved as a first-line NHS treatment for these patients within months.
Developed by Pfizer, lorlatinib works by binding to the ALK protein on the surface of cells, blocking the growth of tumors and ‘stopping the cancer in its tracks’.
Dr. David Spiegel, ASCO’s chief scientific officer, said the industry “hasn’t seen anything close to this.”
He said: “The results with lorlatinib are the best we have ever seen.
“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.”
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The study, led by the Peter MacCallum Cancer Centre, Melbourne, Australia, involved 296 people with advanced ALK-positive lung cancer, with a quarter of the patients already seeing the cancer spread to their brain.
Half were given lorlatinib, while the others were given an existing drug called crizotinib designed to work in a similar way.
Over five years, 60 percent of the lorlatinib group had no progression of their cancer, which the researchers said was “unheard of.”
These results compare to a progression-free survival of just nine months on average elsewhere.
The patients had brain scans every eight weeks and this showed that lorlatinib prevented the cancer from spreading to the brain and stopped the growth of existing brain tumors
Lead author Dr Benjamin Solomon said: “Importantly, around a quarter of patients with ALK+ lung cancer have brain metastases present at the time of diagnosis and progressive CNS involvement remains a major concern for these patients.
“This is the longest progression-free survival ever reported in ALK+ non-small cell lung cancer, and indeed, to our knowledge, of any targeted therapy in lung cancer to date.”
The drug has been available on the NHS since 2020, but only for limited use in patients who have exhausted all other treatment options, with fewer than 100 people receiving it a year.
The results now mean the medical regulator NICE will reassess lorlatinib to provide a new standard of first-line treatment for patients with ALK-positive lung cancer.
Debra Montague, chair of ALK Positive Lung Cancer UK, said: “Lung cancer often spreads to the brain and Lorlatinib has been very successful in stopping this.
“The drug is not yet used for first-line treatment in England, but we hope that following these results it will be approved.”
“ALK-positive lung cancer usually affects patients who have never smoked, and this drug increases the prospect of extending life by many years.”
Professor Charles Swanton, Cancer Research UK’s chief clinician, said: “The ground-breaking results show that over half of patients taking Lorlatinib did not have their disease progress after five years.
“In contrast, over half of the patients taking crizotinib had disease progression after just nine months.
“Research like this is vital to finding new ways to treat lung cancer and help more people survive longer.”