Study of Lorlatinib In People With ALK-positive Non-small Cell Lung Cancer

NCT04362072 | Completed Phase 4 Results FDA Drug

• 2 other identifiers: B74610272019-002504-41
• Study Type: interventional
• Target: 71
• Locations: 7 countries
• Sites: 31

Brief Summary

The purpose of this clinical trial is to learn whether the study medicine (called lorlatinib) is safe and effective for the treatment of non-small cell lung cancer that is caused by an abnormal anaplastic lymphoma kinase (ALK) gene. This study is seeking participants whose lung cancer has progressed after receiving either alectinib or ceritinib as their first treatment. Participants will take part in this study for up to approximately 4 years, depending on when the study is completed and how their cancer responds to the study treatment. They will take lorlatinib orally (by mouth) once daily. Participants will visit the study site about every six weeks to meet with the study team. During these visits, the study team will monitor the safety and effects of lorlatinib.

Conditions

Carcinoma; Non-Small-Cell Lung

Outcome Measures

Primary Outcomes (1)

• Percentage of Participants With Confirmed Overall Objective Response (OR) as Per Independent Central Review (ICR) as Assessed by RECIST v1.1

  Confirmed OR based on ICR assessment was defined as complete response (CR) or partial response (PR) according to response evaluation criteria in solid tumor (RECIST) version(v)1.1 from date of first dose until documented progressive disease (PD) or start of new anti-cancer therapy without regard to discontinuation from treatment. Both CR and PR must be confirmed by repeat assessments performed no less than 4 weeks after criteria for response are first met. CR: disappearance of all target and non-target lesions. PR: at least 30 % decrease in sum of diameters of target, taking as reference baseline sum diameters. PD: at least 20% increase in sum of diameters of target lesions, taking as reference smallest sum on study. In addition to relative increase of 20%, sum must also demonstrate an absolute increase of at least 5 millimeter (mm). Appearance of one or more new lesions was also considered sign of progression. For non-target PD: unequivocal progression of existing non-target lesions.

  From date of first dose until documented PD or start of new anti-cancer therapy, whichever occurred earlier (maximum treatment exposure up to 42.78 months)

Secondary Outcomes (21)

• Percentage of Participants With Confirmed OR as Per Investigator (INV) as Assessed by RECIST v 1.1

  From date of first dose until documented PD or start of new anti-cancer therapy, whichever occurred earlier (maximum treatment exposure up to 42.78 months)

• Percentage of Participants With Confirmed Intracranial (IC) Objective Response (IC-OR) as Per ICR as Assessed by RECIST v 1.1

  From date of first dose until documented PD or start of new anti-cancer therapy, whichever occurred earlier (maximum treatment exposure up to 42.78 months)

• Percentage of Participants With Confirmed IC-OR as Per INV as Assessed by RECIST v 1.1

  From date of first dose until documented PD or start of new anti-cancer therapy, whichever occurred earlier (maximum treatment exposure up to 42.78 months)

• Time to Response (TTR) as Per ICR as Assessed by RECIST v 1.1

  From date of first dose until first documented objective response, CR or PR (maximum treatment exposure up to 42.78 months)

• TTR as Per INV as Assessed by RECIST v 1.1

  From date of first dose until first documented objective response, CR or PR (maximum treatment exposure up to 42.78 months)

Study Arms (1)

Lorlatinib

EXPERIMENTAL

Participants will take 100 mg (four, 25 mg tablets) once daily.

Drug: Lorlatinib

Interventions

Lorlatinib DRUG

25 milligram (mg) tablet

Lorlatinib

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must have evidence of histologically or cytologically confirmed diagnosis of metastatic NSCLC (Stage IV, American Joint Committee on Cancer \[AJCC\] v7.0) that carries an ALK rearrangement.
• Disease Status Requirements: disease progression after alectinib or ceritinib as first line therapy (the study will limit enrollment of participants with best response of progression or indeterminate on prior alectinib to 8 participants). Participants may have had prior chemotherapy, but only if before starting treatment with alectinib or ceritinib.
• Tumor Requirements: All Participants must have at least one measurable target extracranial lesion according to RECIST v1.1. Participants with asymptomatic CNS metastases (including participants controlled with stable or decreasing steroid use within the last 2 weeks prior to study entry) will be eligible. Participants who have leptomeningeal disease (LM) or carcinomatous meningitis (CM) will be eligible if the LM/CM is visualized on magnetic resonance imaging (MRI) or if documented baseline cerebral spinal fluid (CSF) positive cytology is available.
• Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0 or 1.
• Adequate bone marrow functioning, pancreatic function, renal function and liver function
• Acute effects of any prior therapy resolved to baseline severity or to CTCAE Grade ≤1 except for adverse events (AEs) that in the investigator' judgment do not constitute a safety risk for the participant.
• Systemic anti-cancer therapy with alectinib or ceritinib discontinued within a minimum of 5 half-lives prior to first dose of lorlatinib on the study (unless clinically meaningful tumor flare per discretion of the investigator, in which discussion with the sponsor is warranted).
• Male participants are eligible to participate if they agree to use proper contraception during the intervention period and for at least 98 days after the last dose of study intervention
• Female participants are eligible to participate if they are not pregnant or breastfeeding, and agree to use proper contraception during the intervention period and for at least 35 days after the last dose of study intervention.
• Capable of giving signed informed consent and willingness and ability to comply with the study scheduled visits and other procedures.

You may not qualify if:

• Prior ALK TKI treatment or anti-cancer treatment other than first line alectinib or ceritinib.
• Spinal cord compression unless the participant has good pain control attained through therapy, and there is stabilization or recovery of neurological function for the 4 weeks prior to randomization.
• Gastrointestinal abnormalities, including inability to take oral medication; requirement for intravenous alimentation; prior surgical procedures affecting absorption including total gastric resection or lap band; active inflammatory gastrointestinal disease, chronic diarrhea, symptomatic diverticular disease; treatment for active peptic ulcer disease in the past 6 months; malabsorption syndromes.
• Active and clinically significant bacterial, fungal, or viral infection including hepatitis B virus (HBV) or hepatitis C virus (HCV), known human immunodeficiency virus (HIV), or acquired immunodeficiency syndrome (AIDS) related illness.
• Clinically significant vascular (both arterial and venous) and non-vascular cardiac conditions, (active or within 3 months prior to enrollment)
• Participants presenting with abnormal Left Ventricular Ejection Fraction (LVEF) by echocardiogram or Multi-Gated Acquisition Scan according to institutional lower limits.
• Participants with predisposing characteristics for acute pancreatitis according to investigator judgment
• History or known presence of interstitial fibrosis, interstitial lung disease, pneumonitis, hypersensitivity pneumonitis, interstitial pneumonia, obliterative bronchiolitis, and pulmonary fibrosis.
• Other severe acute or chronic medical or psychiatric condition, including recent (within the past year) or active suicidal ideation or behavior, or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the participant inappropriate for entry into this study.
• Evidence of active malignancy (other than current NSCLC, non-melanoma skin cancer, in situ cervical cancer, papillary thyroid cancer, ductal carcinoma in situ (DCIS) of the breast or localized and presumed cured prostate cancer) within the last 3 years prior to randomization.
• Radiation therapy (except palliative to relieve bone pain) within 2 weeks of study entry. Palliative radiation must have been completed at least 48 hours prior to study entry. Stereotactic or small field brain irradiation must have completed at least 2 weeks prior to study entry. Whole brain radiation must have completed at least 4 weeks prior to study entry.
• Prior irradiation to \>25% of the bone marrow.
• Concurrent use of any of the following food or drugs within 12 days prior to the first dose of lorlatinib: known strong CYP3A inducers, known strong CYP3A inhibitors, known CYP3A substrates with narrow therapeutic index, known permeability glycoprotein (P-gp) substrates with a narrow therapeutic index
• Major surgery within 4 weeks prior to enrollment.
• Known prior or suspected severe hypersensitivity to study interventions or any component in their formulations.

Sponsors & Collaborators

• Pfizer: lead

Study Sites (31)

UCI Medical Center/Chao Family Comprehensive Cancer Center

Orange, California, 92868, United States

Location

Rajiv Gandhi Cancer Institute And Research Centre

New Delhi, DEL, 110085, India

Location

Healthcare Global Enterprises

Bengaluru, Karnataka, 560027, India

Location

Bhakti Vedanta Hospital and Research Institute

Thane, Maharashtra, 401107, India

Location

Rajiv Gandhi Cancer Institute And Research Centre

New Delhi, National Capital Territory of Delhi, 110085, India

Location

Fondazione IRCCS San Gerardo dei Tintori

Monza, Lombardy, 20900, Italy

Location

IRCCS Ospedale San Raffaele

Milan, MI, 20132, Italy

Location

Centro Riferimento Oncologico di Aviano - IRCCS SOC Oncologia Medica e dei Tumori Immunocorrelati

Aviano, PN, 33081, Italy

Location

Azienda Ospedaliero Universitaria di Parma

Parma, PR, 43126, Italy

Location

Azienda Ospedaliera San Camillo Forlanini

Roma, ROME, 00152, Italy

Location

AOU San Luigi Gonzaga

Orbassano (TO), TO, 10043, Italy

Location

AO Santa Maria della Misericordia

Perugia, Umbria, 06132, Italy

Location

Azienda Ospedaliera San Giuseppe Moscati

Avellino, 83100, Italy

Location

Ms Pneumed Janusz Milanowski, Katarzyna Szmygin-Milanowska Spolka Jawna

Lublin, 20-064, Poland

Location

Centrum Medyczne EVOMED

Szczecin, 70-382, Poland

Location

Dom Lekarski Centrum Medyczne Outlet Park

Szczecin, 70-784, Poland

Location

Pracownia Medycyny Nuklearnej, 109 Szpital Wojskowy z Przychodnia SP ZOZ

Szczecin, 70-965, Poland

Location

Dom Lekarski S.A.

Szczecin, 71-064, Poland

Location

Hospital Universitario Puerta de Hierro Majadahonda

Majadahonda, Madrid, 28222, Spain

Location

Hospital Teresa Herrera (C.H.U.A.C)

A Coruña, 15006, Spain

Location

Hospital de la Santa Creu i Sant Pau

Barcelona, 08025, Spain

Location

Hospital Universitari Vall d'Hebron

Barcelona, 08035, Spain

Location

Hospital de la Santa Creu i Sant Pau

Barcelona, 08041, Spain

Location

ICO L'Hospitalet (Hospital Duran i Reynals)

L'Hospitalet de Llobregat, 08908, Spain

Location

Hospital Regional Universitario de Malaga

Málaga, 29010, Spain

Location

Hospital Universitario Virgen del Rocio

Seville, 41013, Spain

Location

Hospital Universitari i Politecnic La Fe

Valencia, 46026, Spain

Location

Kantonsspital Graubuenden

Chur, Kanton Graubünden, 7000, Switzerland

Location

Guy's and St Thomas' NHS Foundation Trust

London, SE1 9RT, United Kingdom

Location

NIHR/Wellcome Trust Clinical Research Facility

Manchester, M13 9WL, United Kingdom

Location

The Christie NHS Foundation Trust

Manchester, M20 4BX, United Kingdom

Location

Related Links

• To obtain contact information for a study center near you, click here.

MeSH Terms

Conditions

Carcinoma

Interventions

lorlatinib

Condition Hierarchy (Ancestors)

Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms

Results Point of Contact

• Title: Pfizer ClinicalTrials.gov Call Center
• Organization: Pfizer Inc.

ClinicalTrials.gov_Inquiries@pfizer.com

1-800-718-1021

Study Officials

• Pfizer CT.gov Call Center

  Pfizer

  STUDY DIRECTOR

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 22, 2020
• First Posted: April 24, 2020
• Study Start: September 29, 2020
• Primary Completion: May 29, 2024
• Study Completion: October 23, 2024
• Last Updated: June 11, 2025
• Results First Posted: June 11, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will share

Locations

CH (1); GB (3); IT (8); US (1); IN (4); PL (5); ES (9)