Avelumab–lorlatinib shows efficacy for heavily pretreated ALK-positive NSCLC
medwireNews: The JAVELIN Lung 101 study suggests that the PD-L1 inhibitor avelumab plus the third-generation ALK inhibitor lorlatinib may be a feasible combination in non-small-cell lung cancer (NSCLC) patients with heavily pretreated, advanced ALK-positive disease.
For the phase Ib study, 28 patients who had received any number of prior ALK inhibitor regimens were given avelumab 10 mg/kg every 2 weeks plus lorlatinib 100 mg/day, Alice Shaw, from Massachusetts General Hospital Cancer Center in Boston, USA, told delegates at the ASCO Annual Meeting 2018 in Chicago, Illinois, USA.
One patient achieved a complete response to treatment, 12 a partial response, and six patients stable disease, giving an objective response rate of 46.4% and a disease control rate of 67.9%; median duration of response was 7.4 months although data are not yet mature.
Summing up, Shaw said the combination had a “manageable safety profile” with “no dose-limiting toxicities”, and that “longer follow-up will be important to establish the true durability of these responses and to better assess the potential benefit of combined avelumab and lorlatinib in ALK-positive lung cancer.”
By contrast, a second regimen consisting of avelumab alongside the ALK inhibitor crizotinib 250 mg twice daily was “not well tolerated” by the 12 patients with advanced ALK-negative NSCLC and no previous PD-1 or PD-L1 targeted therapy, she said, with dose-limiting toxicities reported in 41.7%.
With efficacy no greater than expected for avelumab alone, Shaw concluded that “no further development of this combination is planned.”
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