Pfizer's Lorbrena bests Xalkori in PhIII readout — is it a potential successor?
Pfizer has long pinned hopes on lorlatinib as being a successor to Xalkori for ALK-positive non-small cell lung cancer, and the pharma released data Wednesday indicating that may eventually be the case.
Lorlatinib, now marketed as Lorbrena, met its primary endpoint in a Phase III trial by showing a significantly improved progression-free survival as compared to Xalkori in patients who had previously not received any treatment for their illness. Lorbrena had already been approved as a second-line treatment for ALK-positive metastatic NSCLC back in 2018.
Specifically, patients must have tried Xalkori and at least one other ALK-inhibitor, or either Roche’s Alecensa or Novartis’ Zykadia, before being prescribed Lorbrena. If those medications had not stopped the progression of the disease, Lobrena would become an option.
Pfizer was mum on both exact numbers and whether or not the trial met secondary endpoints.
Safety profiles were consistent for both drugs in what had previously been seen in clinical trials. The study was open-label with two arms and enrolled 296 patients with the untreated disease. Individuals were randomized 1-to-1 to receive either Lorbrena or Xalkori treatments.
The NSCLC market is largely dominated by Merck’s Keytruda, but the ALK-positive subset represents about 3% to 5% of patients. It’s in this area where Lobrena will face heavy competition with Roche and Novartis, as Xalkori has struggled to find a foothold with consumers.
Alecensa led the pack in the first quarter of this year, tallying nearly $300 million. Xalkori managed only about half that with $149 million.
Though Xalkori was the first drug approved to treat patients of this nature, Alecensa soon surpassed it by proving better at cutting the risk of disease progression and Zykadia also managed to carve out a spot in the marketplace. But now with Lorbrena topping Xalkori in Pfizer’s own trials, the landscape may soon shift again.