2023 World Conference on Lung Cancer (Posters)-EP12.02. Comparative Efficacy and Safety of Lorlatinib vs Alectinib and Brigatinib Using Matching Adjusted Indirect Comparisons (MAIC)

EP12.02. Comparative Efficacy and Safety of Lorlatinib vs Alectinib and Brigatinib Using Matching Adjusted Indirect Comparisons (MAIC) - PDF(Slides)

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This study compares the efficacy and safety of lorlatinib with two other drugs, alectinib and brigatinib, for the treatment of advanced/metastatic non-small-cell lung cancer (NSCLC). The goal is to generate comparative data on these next-generation ALK tyrosine kinase inhibitors (TKIs) since there are no head-to-head randomized controlled trials.<br /><br />The study uses matching adjusted indirect comparison (MAIC) methods, which adjust for differences in randomized controlled trials (RCTs) including patient characteristics, data maturity, and cross-over. The results are obtained by comparing the efficacy outcomes such as progression-free survival (PFS), objective response, and intracranial time to progression, as well as safety outcomes such as grade 3 adverse events and treatment discontinuation.<br /><br />The study finds that lorlatinib demonstrates superior PFS compared to alectinib and brigatinib. While the risk of grade 3 adverse events is higher with lorlatinib compared to alectinib, there are no significant differences in other safety endpoints. These findings support the use of lorlatinib as a first-line treatment option for ALK advanced/metastatic NSCLC.<br /><br />It is important to note that the study has limitations, including potential residual confounding from unmeasured or unreported effect modifiers and differences in follow-up times across trials. The safety conclusions also do not represent all possible adverse events. Additionally, the results may not be generalizable to the intention-to-treat population due to the exclusion of Chinese patients from the analysis.<br /><br />Overall, this study contributes to the evidence on the comparative efficacy and safety of lorlatinib as a first-line treatment for ALK advanced/metastatic NSCLC.

Asset Subtitle

Christine Garcia

Meta Tag

Speaker Christine Garcia

Topic Metastatic NSCLC: Targeted Therapy - FUSIONS

Keywords

lorlatinib

alectinib

brigatinib

non-small-cell lung cancer

NSCLC

tyrosine kinase inhibitors

progression-free survival

objective response

intracranial time to progression

grade 3 adverse events