By Kate Pickles Chicago health editor
1:01 PM May 31, 2024, updated 3:29 PM May 31, 2024
Patients with incurable lung cancer could see their lives extended by several years with a drug hailed as the ‘best’ ever treatment for the disease.
About six in 10 patients given the daily tablet and treated with lorlatinib survived for five years without their cancer getting worse, compared to just eight percent who received standard care.
Scientists said the results were ‘off the charts’ after a study found it improved survival rates by 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 life extended because the majority still live progression-free.
The study involved 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.
Typically non-smokers who are younger than the average lung cancer patients, around 350 people in Britain are diagnosed with ALK-positive lung cancer every year.
Experts hope that lortlatinib will be approved as a first-line treatment for these patients within months.
Lorlatinib, developed by Pfizer, works by binding to the ALK protein on the surface of cells, blocking tumor growth and ‘stopping cancer in its tracks’.
Dr. David Spigel, 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 haven’t seen these kinds of results very often in oncology, let alone in non-small cell lung cancer.
“These are among the best results we’ve seen in advanced disease in any context… a truly major step forward in lung cancer care.”
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The study was led by the Peter MacCallum Cancer Centre, Melbourne, Australia, and involved 296 people with advanced ALK-positive lung cancer, with a quarter of patients having already seen the cancer spread to their brain.
Half received lorlatinib, while the others received an existing drug called crizotinib, which was designed to work in a similar way.
Over five years, 60 percent of the lorlatinib group experienced no progression of their cancer, which scientists said was “unheard of.”
These results compared with progression-free survival that averaged only nine months elsewhere.
Patients received brain scans every eight weeks, which showed that lorlatinib prevented the cancer from spreading to the brain and existing brain tumors from growing.
Lead author Dr. Benjamin Solomon said: ‘Importantly, approximately a quarter of patients with ALK+ lung cancer have brain metastases at the time of diagnosis and progressive CNS involvement remains a major problem for these patients.
‘This is the longest progression-free survival ever reported in ALK+ non-small cell lung cancer, and, 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 per year.
The results now mean that the medical regulator NICE will reassess lorlatinib to provide a new standard 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 is very successful in stopping this.
‘The drug is not yet in use as a first-line treatment in England, but hopefully it will gain approval following these results.
‘ALK-positive lung cancer usually affects patients who have never smoked and this drug increases the chance of extending life by many years.’
Professor Charles Swanton, Chief Physician at Cancer Research UK, said: ‘The groundbreaking results show that more than half of patients taking Lorlatinib had no progression of their disease after five years.
‘In contrast, more than half of patients taking Crizotinib experienced disease progression after just nine months.
‘Research like this is essential to find new ways to treat lung cancer and help more people survive longer.’