Is there still a room for crizotinib in first-line setting in ALK-positive NSCLC patients?

24 / 39

Sequence more difficult in next future
R
Advanced NSCLC, ALK+
Asymptomatic CNS allowed
PS 0-2
NCT03052608 Crizotinib
250 mg BID
Lorlatinib
100 mg QD
Primary End Point: PFS
N=280
PD
Toxicity
Or death
R
Advanced NSCLC, ALK+. PS 0-2.
Asymptomatic CNS allowed
NCT02767804 Crizotinib
250 mg BID
Ensartinib X-396
225 mg QD
Primary End Point: PFS
N=402
PD
Toxicity
Or death
EXALT3
CROWN
Horn – CCR 2018 * Solomon – Lancet Oncol 2018
*Ensartinib phase I/II in ALK TKI-naïve patients: RR 80%, PFS 26.2 mo.
*Lorlatinib phase II in ALK TKI-naïve patients (N=30): RR 90%, PFS Not reached. icRR 67%
Is the optimal control treatment arm?
Best strategy at the time of PD?