2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12B.08 Characterizing the Severity and Timing of Real-World ALK-Inhibitor Associated Weight Gain in Non-Small Cell Lung Cancer

EP.12B.08 Characterizing the Severity and Timing of Real-World ALK-Inhibitor Associated Weight Gain in Non-Small Cell Lung Cancer

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This study examines the severity and timing of weight gain in patients with Non-Small Cell Lung Cancer (NSCLC) treated with Anaplastic Lymphoma Kinase (ALK) tyrosine kinase inhibitors (TKIs). These TKIs, including crizotinib, brigatinib, alectinib, and lorlatinib, have shown metabolic side effects such as weight gain in clinical trials. Lorlatinib, in particular, has a higher incidence of severe weight gain compared to its predecessors. For instance, the CROWN trial highlighted that 44% of lorlatinib patients experienced grade 1-3 weight gain, with 23% at grade 3, compared to 13% and 2% for crizotinib, respectively.<br /><br />The study's primary aim was to characterize weight gain in a real-world cohort of ALK NSCLC patients, assessing factors such as timing, severity, and associated baseline characteristics. Secondary objectives included identifying risk factors that could facilitate improved monitoring and intervention strategies, particularly for lorlatinib.<br /><br />Employing a retrospective cohort design at the University of Colorado, data from 95 patients and 180 therapy lines were analyzed. Results indicated that severe weight gain was more common with lorlatinib, beginning early in treatment and increasing over time. Statistical analyses (ANOVA and chi-square tests) confirmed significant weight changes, with lorlatinib being the strongest predictor of weight gain in both univariate and multivariate models. Interestingly, baseline obesity, hypertension, or diabetes did not correlate with weight gain in lorlatinib-treated patients, though those developing grade 2-3 dyslipidemia on lorlatinib had higher weight gain.<br /><br />The study underscores the need for more tailored interventions for weight management as lorlatinib becomes more prevalent in first-line treatment. Future work should focus on validating these findings across larger cohorts and exploring weight loss medication efficacy in this context. This research provides critical insight for clinician-patient decision-making regarding ALK TKI treatment, particularly regarding managing potential side effects.

Asset Subtitle

Alexander Watson

Meta Tag

Speaker Alexander Watson

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

Non-Small Cell Lung Cancer

ALK tyrosine kinase inhibitors

weight gain

lorlatinib

CROWN trial

real-world cohort

risk factors

retrospective cohort design

University of Colorado

weight management