NCCN Guidelines recommend lorlatinib for second-line ROS1+ NSCLC

The new National Comprehensive Cancer Network (NCCN) Guidelines for non-small cell lung cancer (NSCLC) added lorlatinib as a ROS1 treatment option, after progression on crizotinib or ceritinib. This means most insurance should start covering lorlatinib for ROS1.

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer (Version 2.2019)
(subscription required, but it’s free)

  • Subsequent Therapy for ROS1 Rearrangement-Positive Metastatic NSCLC

    • Lorlatinib (category 2A) added as a treatment option, after progression on crizotinib or ceritinib.

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Gray Connections

I was diagnosed with non-small cell lung cancer in May 2011. The cancer became metastatic in October 2011. No, I never smoked anything (except a salmon). I've had no evidence of disease since January 2013 thanks to precision medicine, clinical trials, and other patients. ANYONE can get lung cancer. Using my engineering degrees (MIT SBME 1978, Caltech Aeronautics MS 1984 and ENGR 1986), I enjoyed a 20-year career in aerospace systems engineering as a technical translator of sorts: I researched a scientific or engineering subject and helped others understand how this new gizmo could benefit them. In the time I have left, I want to use my skills to help others who have lung cancer, and increase the visibility and knowledge of lung cancer among those who don't. I also study brain research, enjoy traveling, write science fiction, and geek out about all sorts of science stuff.

2 thoughts on “NCCN Guidelines recommend lorlatinib for second-line ROS1+ NSCLC

    1. It’s a battle to get a targeted therapy approved for the first time in any country. Pfizer has Phase 3 crizotinib trial data for ALK NSCLC, which has proven essential in getting the drug approved in many countries with national health systems. Because ROS1 is a small population, no phase 3 data for crizotinib exists, so it’s more difficult to get crizotinib approved for ROS1 (It’s still not approved in Canada or Australia, despite years of trying).


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