Pfizer announced on Friday that its drug, Lorbrena, has shown promising long-term results in a late-stage trial for an advanced form of lung cancer. The drug helped patients live longer without cancer progression, with most people experiencing this benefit for over five years. Additionally, it reduced the risk of the cancer progressing in patients’ brains, which is especially significant as this type of lung cancer often spreads to the brain.
Lorbrena is already approved in the U.S. for treating adults with advanced non-small cell lung cancer who have a specific gene mutation called ALK. Although only about 5% of all non-small cell lung cancer patients have this mutation, it still translates to around 72,000 people worldwide who are diagnosed with this form of lung cancer each year. This particular type of lung cancer is aggressive and commonly affects younger individuals.
While Lorbrena is currently approved as a first-line treatment for this specific form of lung cancer, it is not considered the standard treatment. However, Pfizer believes that the new five-year data on the drug will change that. Chris Boshoff, Pfizer’s chief oncology officer, stated that in cancer medicine, the goal is always to provide the best medicine upfront. Therefore, Pfizer aims for Lorbrena to become the standard first-line treatment for this type of lung cancer.
The new five-year data comes from the same phase three trial that led to Lorbrena’s U.S. approval. At the five-year mark, 50% of patients in the trial were still receiving Lorbrena compared to only 5% receiving Pfizer’s older lung cancer drug, Xalkori. Lorbrena reduced the risk of cancer progression or death by 81% compared to Xalkori after five years. Additionally, approximately 60% of patients treated with Lorbrena were alive without cancer progression after the same period, compared to only 8% among those who took Xalkori.
Dr. David Spigel, chief scientific officer at the Sarah Cannon Research Institute, described these results as the best ever seen in lung cancer treatment. He emphasized that other available drugs have not reported such significant events of durable, progression-free survival. It is important to note that there are no head-to-head trials comparing Lorbrena with competing lung cancer drugs, such as alectinib and brigatinib. However, Spigel believes it is unlikely that Lorbrena would perform worse against these drugs.
Lung cancers with the ALK-positive mutation are particularly prone to spreading to the brain. Lorbrena demonstrated a 94% reduction in the risk of cancer progression in the brain compared to Pfizer’s old drug. Only four out of 114 patients taking Lorbrena developed brain metastases within approximately 16 months, while 39 out of 109 taking Xalkori developed brain metastases. Lorbrena’s effectiveness in preventing and treating brain metastasis is attributed to its ability to cross the blood-brain barrier and enter the brain.
Lorbrena did not present any new safety issues in the trial. The most common side effects included swelling, weight gain, cognition and mood changes, and high cholesterol in the blood. However, cognitive issues associated with Lorbrena were considered unusual, as they are not seen with its competitors. Dr. Andrew Berens, an analyst from Leerink Partners, suggests that these central nervous system side effects may be the reason why Lorbrena is often used as a second-line treatment rather than a first-line treatment for this advanced form of lung cancer. Boshoff from Pfizer mentioned that educating physicians on how to manage these adverse effects will be crucial for Lorbrena’s relaunch following the release of the new data.
Overall, Pfizer’s drug Lorbrena has shown remarkable long-term results in the treatment of an advanced form of lung cancer. The data indicates that Lorbrena may become the new standard first-line treatment for this specific type of lung cancer, as it has demonstrated superior efficacy and safety compared to existing drugs. The reduction in cancer progression and brain metastases is especially significant, as these are common challenges faced by patients with this form of lung cancer. The introduction of Lorbrena as a first-line treatment has the potential to greatly improve outcomes and quality of life for patients diagnosed with this aggressive disease.
