Given potential long-term CV toxicity concerns with lorlatinib and data suggesting that dose reduction does not compromise efficacy, do you ever recommend initiating and/or maintaining lower-dose lorlatinib in ALK+ NSCLC?  

I do not typically empirically reduce the dose of lorlatinib at initiation, though, I know some practitioners who do. With appropriate monitoring, including lipid and triglyceride levels, periodic electrocardiograms, and echocardiography (baseline and if clinically indicated), I am comfortable with ...

It depends. I'm a firm believer in the maximum dose a patient can tolerate and do well on with minimal side effects and maintain a strong quality of life as they live with this for a long time. For an older patient, I would start at 75 mg but for young, I would start at 100 and a low threshold to re...