Phase 3 Study Demonstrates Intracranial Response in ALK+ NSCLC

Benjamin Solomon, MBBS, PhD, discusses the intracranial responses observed in the CROWN trial of lorlatinib versus crizotinib in patients with ALK-positive non–small cell lung cancer.

Benjamin Solomon, MBBS, PhD, consultant medical oncologist, professor, group leader, Molecular Therapeutics and Biomarkers Laboratory, Research Division, Peter MacCallum Cancer Center, discusses the intracranial responses observed in the CROWN trial of lorlatinib (Lorbrena) versus crizotinib (Xalkori) in patients with ALK-positive non–small cell lung cancer (NSCLC).

The intracranial activity seen with lorlatinib was 1 of the most important findings in this phase 3 study, according to Solomon. All the patients on the trial received baseline MRIs and serial assessments of disease in the brain with subsequent MRI scans which were independently reviewed.

In patients with measurable brain metastases, the intracranial objective response rate by independent review was 82% with lorlatinib compared with 23% with crizotinib. The intracranial complete response rate was 71% with lorlatinib in these patients with ALK-positive NSCLC.

The time to intracranial progression showed a hazard ratio of 0.70. Solomon says this is a remarkable result and speaks to the ability of lorlatinib in its ability to not only delay progression of existing metastases, but also potentially prevent the development of new brain metastases.