Is there a preferred ALK targeting agent for patients with ALK+ mNSCLC presenting with CNS metastases?
For a patient with ALK+ mNSCLC presenting with CNS metastases, my preferred first line treatment is:
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We do not have head-to-head comparisons and thus bearing the caveats of cross-trial comparisons given the heterogeneity in patients enrolled (e.g. baseline brain mets and type of treatment received), we do this exercise given the limitations of available data. There are considerable differences in b...
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As mentioned above, with the approval of lorlatinib, likely to consider lorlatinib.
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In the CROWN trial, the hazard ratio for survival without CNS progression was 0.07 (95% CI, 0.03-0.17). The cumulative 12-month rate of CNS progression on lorlatinib was only 2.8% (95% CI, 1.0-8.1). In my personal experience, in patients with severe, symptomatic CNS disease, the rates of response, d...
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