Alice T. Shaw, MD, PhD, associate professor of medicine, Harvard Medical School, attending physician, Thoracic Cancer Program, Massachusetts General Hospital, discusses lorlatinib in the treatment of patients with lung cancer.
Lorlatinib is third-generation ALK/ROS1 tyrosine kinase inhibitor (TKI). Shaw says it is important to note that this agent is a third-generation TKI because it was specifically designed to overcome known ALK resistance mutations, as well as penetrate the blood-brain barrier. Lorlatinib has been shown to be very potent compared with the first- and second-generation TKIs such as ceritinib (Zykadia), alectinib (Alecensa), and brigatinib (Alunbrig).
Phase I and II testing of lorlatinib has been completed in patients with ALK-positive and ROS1-rearranged lung cancers. The FDA has granted a priority review designation to a new drug application for lorlatinib for use in patients with ALK-positive metastatic non–small cell lung cancer who have progressed on 1 or more ALK TKIs.