Introduction

The drug lorlatinib (trade name EU: Lorviqua, U.S.: Lorbrena) has been approved in Germany since May 2019 for the treatment of advanced non-small-cell lung cancer. It can be used in adults who have already had treatment and who have certain mutated cancer cells that can lead to faster tumor growth.

Lung cancer is caused by the growth of malignant cells in the airways (bronchi) and their branches (bronchioles). That is why this kind of cancer is also called bronchial carcinoma. There are two main types of lung cancer:

  • Small-cell lung cancer (SCLC)
  • Non-small-cell lung cancer (NSCLC)

NSCLC is surgically removed, if possible. But sometimes the tumor has already become too large or the cancer has spread to other parts of the body (metastasis) through the blood or lymphatic system. If this has happened, it is considered to be advanced lung cancer.

Some people with NSCLC have an abnormal enzyme in the tumor tissue called anaplastic lymphoma kinase (ALK). The full name of the cancer is then ALK-positive non-small-cell lung cancer. The enzyme ALK can lead to uncontrolled growth of the tumor tissue.

Lorlatinib is an ALK inhibitor. It is used to try to block the ALK enzyme and slow further tumor growth.

Application

Lorlatinib is available in tablet form, in two different doses (25 and 100 mg). The recommended dose is 100 mg a day. The dose can be lowered if the drug isn't well tolerated. Treatment is stopped if the disease gets worse or if very severe side effects arise.

Other treatments

People with advanced ALK-positive lung cancer who have already been treated with another ALK inhibitor have various other cancer treatment options, depending on the treatment they have had so far. These options include alectinib, ceritinib or chemotherapy. The treatment is individually adjusted by a doctor.

If further cancer treatment isn't possible, then they will receive best supportive care (BSC). This treatment should be tailored to the patient’s individual needs, relieve symptoms such as pain, and improve their quality of life.

Assessment

In 2019, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) wanted to find out whether lorlatinib has any advantages or disadvantages compared with the current standard treatments for people with advanced ALK-positive lung cancer who have already had treatment.

But the manufacturer didn’t provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of lorlatinib (Lorviqua, Lorbrena).