2022 World Conference on Lung Cancer (ePosters)-EP08.02-124. Lorlatinib Treatment Related Adverse Events: Single Centre Real-World Experience in ALK and ROS1-driven NSCLC

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A single-center study examined the real-world experience of lorlatinib treatment-related adverse events (TRAEs) and efficacy in patients with ALK- and ROS1-driven non-small-cell lung cancer (NSCLC). The study found that lorlatinib is an effective treatment for these types of NSCLC, but TRAEs, particularly mood abnormalities and neurocognitive disturbances, occur frequently and require careful monitoring. However, TRAEs are manageable with dose interruptions, reductions, and the use of supportive medication.<br /><br />The study included 33 patients who were initiated on a 100mg dosage of lorlatinib. Of these patients, 45% required treatment interruption, most commonly due to edema in the limbs and mood disturbances. However, they were able to restart treatment. Additionally, 36% of patients required dose reduction, primarily due to mood disturbances and edema in the limbs. Some patients were able to tolerate rechallenge at the same dose. Furthermore, 22 patients discontinued lorlatinib, primarily due to disease progression. Only one patient discontinued due to a grade 3 pneumonitis that was not treatment-related but was a result of acute COVID-19 infection. No grade 5 TRAEs were reported.<br /><br />A few patients experienced severe TRAEs, including grade 4 depression and thoughts of self-harm, as well as grade 4 psychosis and later grade 3 psychotic depression after lorlatinib dose re-escalation. These symptoms were managed with antidepressant and anti-psychotic medications, and lorlatinib was tolerated at a reduced dose level.<br /><br />The study also provided information on patient demographics, including age, gender, smoking history, NSCLC subtype, and prior lines of treatment. Efficacy outcomes were also assessed, with an extracranial objective response rate of 47.8% and a CNS objective response rate of 70%.<br /><br />In conclusion, this real-world study highlights the importance of monitoring and managing TRAEs in patients receiving lorlatinib for ALK- and ROS1-driven NSCLC. Despite the occurrence of TRAEs, lorlatinib demonstrated efficacy in treating these types of lung cancer.

Asset Subtitle

Parvin Begum

Meta Tag

Speaker Parvin Begum

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

lorlatinib

treatment-related adverse events

efficacy

ALK-driven NSCLC

ROS1-driven NSCLC

mood abnormalities

neurocognitive disturbances

dose interruptions

dose reductions

supportive medication