New lung cancer pill hailed as ‘off the charts’ success

Patients with incurable lung cancer could have their lives extended by several years with the help of a drug that has been declared the ‘best ever’ to treat the disease.

About six in ten patients who took a daily pill treated with lorlatinib survived five years without the cancer progressing, compared with just eight percent who received standard care.

Scientists said the results were ‘off the charts’ after a trial found it improved survival rates for the longest time ever recorded.

Researchers who presented the findings at the American Society of Clinical Oncology conference in Chicago said it was impossible to say how much it prolongs life because most are still living without progression.

The research 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 patient, around 350 people in the UK are diagnosed with ALK-positive lung cancer each year.

Experts hope that lortlatinib will be approved as 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 tumor growth and ‘stopping cancer in its tracks’.

dr. David Spigel, chief scientific officer of ASCO Specialists, said the industry had ‘not seen anything like this’.

He said: ‘The results with lorlatinib are the best we have ever seen.

‘It’s just that we haven’t seen such results so often in oncology, and even less so 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 the treatment of lung cancer.’

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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 did not experience cancer progression, which the researchers said was ‘unheard of’.

These results compare to progression-free survival, which elsewhere averages just nine months.

Patients underwent brain scans every eight weeks, which showed that lorlatinib prevented the cancer from spreading to the brain and stopped the growth of any 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 lung cancer therapy to date.’

The drug is available on the NHS from 2020, but only for limited use in patients who have exhausted all other treatment options, with fewer than 100 people a year.

The results now mean that the medical regulator NICE will reassess lorlatinib to make it the 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 used as a first-line treatment in England, but we hope it will be approved after these results.

‘ALK-positive lung cancer usually affects patients who have never smoked, and this drug increases the chances of extending life by many years.’

Professor Charles Swanton, Cancer Research UK’s chief clinician, said: ‘The ground-breaking results show that more than half of patients taking Lorlatinib did not have disease progression after five years.

‘In contrast, more than half of the patients taking Crizotinib had disease progression after just nine months.

‘Research like this is key to finding new ways to treat lung cancer and help more people live longer.’