MILAN (ITALPRESS) – Seven years after the start, the CROWN study confirms that lorlatinib offers the longest-lasting free survival of progression (PFS) in non-small cell lung cancer (NSCLC) ALK-advanced device. The international phase 3 trial, which rated lorlatinib – third-generation ALK inhibitor developed by Pfizer – compared to crizotinib in patients with NSCLC ALK-advanced device not previously treated, demonstrates a median PFS not yet reached, 55% of patients still in response and a reduction of 94% of the risk of intracranial progression. The seven-year update consolidates the results already observed at the five-year follow-up, confirming the duration of the clinical benefit in the long term. In Italy, about 108,900 people live with lung cancer, with 43,500 new cases estimated in 2025. Non-small cell lung carcinoma (NSCLC) represents about 80-85% of all lung cancers. Within this population, 3-5% of cases have a rearrangement of the ALK gene, often associated with younger and frequently non-smoking patients. One of the main clinical issues in this indication is the involvement of the central nervous system: up to 40% of patients develop brain metastases in the first two years of diagnosis, making intracranial control an essential component in the evaluation of therapy. “The follow-up to seven years of the CROWN study represents a significant step in the evolution of the target therapies for cancer of the ALK-positive lung,” says Federico Cappuzzo, Director of Medical Oncology 2 of the National Institute Tumori IRCCS Regina Elena of Rome. “The median PFS not yet achieved, along with a probability of 55% remaining free from progression, highlights a prolonged disease control that, until a few years ago, would have been hardly hypothetical. The reduction of 94% of the risk of intracranial progression significantly redefines current expectations towards a first-line target therapy in this setting.” For the clinic that daily manages the NSCLC ALK-advanced device, the data at seven years of CROWN study is a solid reference point in support of therapeutic decisions. However, the possibility of transferring these benefits to clinical practice is crucially dependent on the early identification of molecular alteration at the basis of the disease. The identification of ALK rearrangement is a fundamental stage of the diagnostic path, indispensable to direct the patient to targeted therapies on the oncogenic driver. “In non-small ALK-positive lung cancer, early molecular diagnosis is the indispensable prerequisite for target therapies to express all their potential and significantly change clinical course. The timely and systematic identification of ALK’s alteration allows to identify patients who can benefit from the most effective targeted therapies since the beginning,” says Silvia Novello, Director of the AOU San Luigi Gonzaga of Orbassano, Professor of Medical Oncology at the Department of Oncology of the University of Turin and President of the Women Against LCE Patient Association. “The results of the CROWN study are of absolute relevance in a pathology that often affects young patients, with a high tendency to brain involvement: it consolidates, in fact, the possibility of reasoning in terms of prolonged control of the disease, exceeding the traditional logic of the only response to treatment. A paradigm shift with concrete implications for planning the path of care and patient management, opening new future perspectives.” From the clinical meaning of CR dataOWN also emerges the value of a research path built over time, in which the contribution of pharmaceutical innovation is an integral part of the evolution of precision medicine in lung cancer.“The updated results at seven years of the CROWN study highlight a lasting and unprecedented clinical benefit: the data indicate that most patients with advanced lung cancer ALK-positive is alive and free from a concrete progression of disease. “The CROWN study shows how identifying a target driver and its targeted treatment can significantly change the natural history of the disease. These results further enhance Pfizer’s contribution to oncological research and confirm our commitment to developing innovative solutions to improve patient care with advanced lung cancer.” -photo f12/Italpress – (ITALPRESS).
