LIVE EHA 2026 Live from Stockholm — KOL insights, late-breaker trials & top physician voices View Live Updates →
KOL Pulse — Trial Profile

CROWN Trial

Phase 3 trial of lorlatinib (Lorbrena) vs crizotinib as first-line therapy for advanced ALK-positive NSCLC. The 7-year update presented at ASCO 2026 (Abstract 8502) — among the longest Phase 3 follow-up datasets ever reported in 1L NSCLC — shows the median PFS still not reached, with KOLs calling it practice-defining for ALK+ disease.

ASCO 2026 · Abstract 8502 · 7-Year UpdateALK+ NSCLC1st-LinePhase 3Lorlatinib (Lorbrena) · Pfizer

KOL Leaders Discussing CROWN

Charu Aggarwal, MD, MPH, FASCO
Charu Aggarwal, MD, MPH, FASCO
@CharuAggarwalMD
34,928 impressions
gilberto lopes
gilberto lopes
@GlopesMd
34,092 impressions
Laura Alder, MD
Laura Alder, MD
@LauraAlderMD
29,150 impressions
Normand Blais, MD 🌻
Normand Blais, MD 🌻
@NormandBlais
22,867 impressions
Paolo Tarantino
Paolo Tarantino
@PTarantinoMD
21,119 impressions
Marcelo Corassa, MD.
Marcelo Corassa, MD.
@MarceloCorassa
20,208 impressions
Vinay Prasad MD MPH
Vinay Prasad MD MPH
@VPrasadMDMPH
16,887 impressions
Nathan A. Pennell MD, PhD, FASCO
Nathan A. Pennell MD, PhD, FASCO
@n8pennell
15,482 impressions

Key Slides & Data

Stephen V Liu, MD
Stephen V Liu, MD @StephenVLiu
#ASCO26 · May 29, 2026
View Post
2026ASCO ANNUAL MEETING --- PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PFS, % 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% 10% 10% years with 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib a confidence interval, MR, harard ratio, ITT, infention to boat, NR, not reached; PFS, progression free survival 2026 ASCO #ASCO26 PRESENTED BY Tony S.K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO - OF ORICAL ANNUAL MEETING Presentation - property of the - and ABCO Permission required for - contact KNOWLEDGE CONQUERS CANCER --- PFS in Prespecified Patient Subgroups Number of events/ Number of patients, n (%) number of patients (n/N) Subgroup Lorlatinib Crizotinib Lorlatinib Crizotinib Hazard ratio (95% CI) All patients (stratified) 149 (100) 147 (100) 62/149 119/147 0.19 (0.13-0.26) All patients (unstratified) 149(100) 147 (100) 62/149 119/147 0.20 (0.15-0.28) Presence of brain metastases Yes 35 (23) 38 (26) 18/35 34/38 0.08 (0.04-0.19) No 114 (77) 109 (74) 44/114 85/109 0.23 (0.16-0.34) Ethnic origin Asian 66 (44) 65 (44) 30/66 51/65 0.24 (0.15-0.39) Non Asian 83 (56) 82 (56) 32/83 68/82 0.18 (0.11-0.28) ECOG performance status 0-1 146 (98) 138 (94) 60/146 111/138 0.20 (0.14-0.28) Gender Male 65 (44) 56 (38) 29/65 48/56 0.23 (0.14-0.38) Female 84 (56) 91 (62) 33/84 71/91 0.19 (0.12-0.29) Age < 65 years 89 (60) 103 (70) 29/89 86/103 0.15 (0.10-0.24) >65 years 60 (40) 44 (30) 33/60 33/44 0.27 (0.16-0.46) Smoking status Never 81 (54) 94 (64) 34/81 78/94 0.17 (0.11-0.27) Current/former 68 (46) 52 (35) 28/68 40/52 0.26 (0.16-0.44) Extent of disease Metastatic 135 (91) 139 (95) 55/135 114/139 0.19 (0.13-0.26) Histology Adenocarinoma 140 (94) 140 (95) 55/140 113/140 0.19 (0.13-0.26) 0.0625 0.25 0.5 1 2 Favors lorlatinib Favors crizotinib PFS benefit was consistent across all prespecified subgroups, including those with/without brain metastases and Asian/non-Asian patients CI, confidence interval; ECOG, Eastern Cooperative Oncology Group: PFS, progression free survival 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asco.org KNOWLEDGE CONQUERS CANCER
Dr Rishabh Jain
Dr Rishabh Jain @DrRishabhOnco
#ASCO26 · May 29, 2026
View Post
CROWN: A Randomized, Global, Phase 3 Study Primary endpoint Lorlatinib 100 mg once daily Key eligibility criteria n=149 PFS by BICR Stage IIIB/IV ALK+ NSCLC Key secondary endpoint No prior systemic treatment for OS Stratified by: metastatic disease Presence of brain metastases Other secondary endpoints ECOG PS 0-2 Randomized (yes vs no) PFS by investigator Asymptomatic treated or untreated 1:1 Ethnicity ORR by BICR and investigator CNS metastases were permitted N=296 (Asian vs non-Asian) IC ORR, IC TTP. DOR, IC DOR, TTR and IC TTR by BICR and 21 extracranial measurable target Crizotinib 250 mg twice daily investigator lesion (RECIST 1.1) with no prior radiation required n=147 Safety Quality of life No crossover between treatment arms was permitted Biomarker analyses In this post hoc analysis with 7 years of follow-up, we present investigator-assessed efficacy outcomes, safety, and biomarker analyses (data cutoff: October 31, 2025) At data cutoff, the required number of OS events for a protocol-specified second interim analysis (at least 139 deaths) has not been reached; 123 of 296 (42%) discontinued the study in both arms due to death ALK, anaplastic tymphoma knase; BICR binded independent central review, CNS, central nervous system DOR, duration of response ECOG Eastern Cooperative Oncology Group HR, hazard ratio; IC intracranial NSCLC non-small cell lung cancer, ORR, objective response rate, OS, overall survival PFS. progression free survival PS performance status, RECIST Response Evaluation Critena in Sold Tumors TTP. time to tumor progression TTR, time to tumor response *Defined as the time from randomization to RECIST defined progression or death due to any cause 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok. MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN CUNCAL ONCOLOGY ANNUAL MEETING Presentation property of the author and ASCO Permission required for - permissions@asco.org KNOWLEDGE CONQUERS CANCER --- PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PFS, % 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% 10% 10% years with 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib CI, confidence interval HR, hazard ratio, ITT, intention to treat, NR not reached PFS, progression free survival 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO CUNICAL ONCOLOGY ANNUAL MEETING Presentation - property of the author and ASCO Permission required for - conted KNOWLEDGE CONQUERS CANCER --- Time to IC Progression by Brain Metastases With baseline brain metastases Without baseline brain metastases Lorlatinib Crizotinib Lorlatinib Crizotinib (n=35) (n=38) (n=114) (n=109) Events, n 5 26 Events, n 4 40 Time to IC progression, NR 7.2 Time to IC progression, NR 23.9 months, median (95% CI) (NR-NR) (3.7-11.0) months, median (95% CI) (NR-NR) (16.4-30.8) HR (95% CI) 0.03 (0.01-0.13) HR (95% CI) 0.04 (0.02-0.12) 96% 96% 96% 96% 96% 96% 100 100 90% 90 83% 83% 83% 83% 83% 90 Patients without IC progression, % 80 80 70 Patients without IC progression, % 70 60 60 50 50 40 40 30 30 49% 33% 20 20 33% 29% 29% 10 10 22% 0 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96100 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96100 No. at risk Months No. at risk Months Loriatinib 35 32 29 28 28 26 26 25 22 22 20 20 20 20 20 20 18 18 18 18 17 11 7 3 1 0 — Lortatinib 114 96 90 84 77 72 70 67 67 64 64 61 61 60 58 56 54 51 51 50 47 30 22 6 1 0 — Crizotinib 109 86 63 41 31 21 19 18 12 10 10 10 9 8 8 7 6 6 6 5 2 2 0 0 0 0 Sustained plateau in time to IC progression indicates a prolonged protective effect against the development of new brain metastases and a sustained control of the existing ones CI, confidence interval HR, hazard ratio, IC intracranial; NR, not reached 2026 ASCO #ASCO26 PRESENTED BY: Tony S.K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO CUNICAL ONCOLOGY ANNUAL MEETING Presentation - property of the author and ASCO Permission required for - contact KNOWLEDGE CONQUERS CANCER --- Conclusions After 7 years of follow-up in the phase 3 CROWN study, with lorlatinib treatment: PFS exceeds 7 years with 7-year PFS of 55% 2026ASCO ANNUAL MEETING Patients without progression within 24 months on lorlatinib had a 79% probability of being alive and free of progression at 7 years PFS benefit was consistent across all prespecified subgroups 7-year IC time to progression was 92%, with a sustained plateau from 30 months onward, indicating long-term CNS protection OS follow-up is ongoing and results will be presented in the future No new safety signals were identified, and all treatment-related discontinuations occurred within the first 26 months ctDNA analysis showed no emerging new ALK resistance mutations Early progressors had a higher number of alterations and a higher tumor mutation burden compared with long-term responders ALK inaplistic tymphoms knase CNS contral norvous system, clDNA, circulating turnor DNA K. intracranial os, overall survival PFS, progression free survival 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN CUNICAL CHOCOLOGY ANNUAL MEETING Presentation - property of the author and ASCO Permission wgared for - contact KNOWLEDGE CONQUERS CANCER
David Gandara
David Gandara @drgandara
#ASCO26 · May 29, 2026
View Post
2026ASCO PFS in the ITT Population (7-Year Follow-Up) ANNUAL MEETING The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS. median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PF PFS, % 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% 10% 10% years with 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) - Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 - Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib C, confidence intervet HR haved rate, ITE, visition to treat, NR, not eached, PFS, progression the survival 2026 ASCO ASCO26 PRESENTED RY: Tony $. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO ANNUAL MEETING I I - - seried KNOWLEDGE CONQUERS CANCER LOSS SSO ASCO A SCO ASCO --- ASCO Estimated Proportion of PFS Events With Lorlatinib MEETING Conditional PFS beyond 2 years PFS Measure estimate Estimated proportion of PFS events 100 PFS at years 70% PFS at years 55% 90 *Conditional 80 79% 70% PFS (7Y/2Y) 20% 70 "Estimated as the ratio of the 10% 55% Kaplan-Meler PFS estimates at 7 60 5% and 2 years: (55%/70%) 2% PF PFS, % 3% 50 3% 2% 40 30 20 10 0 Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 No. at risk - Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Patients without a PFS event in the first 24 months on lorlatinib have a 79%* probability of remaining alive and progression-free at 7 years PFS, progression free survival 2026 ASCO PRESENTED BY: Tony S.K. Mok, MD (tony@clo.cuhk.edu.hk) #ASCO26 ASCO ANNUAL MEETING I property author ASCO Permission I - I contact KNOWLEDGE CONQUERS CANCER ASCO ASCO ASCO ASCO ASCO ASCO
Balazs Halmos
Balazs Halmos @BalazsHalmosMD
#ASCO26 · May 29, 2026
View Post
2026ASCO ANNUAL MEETING --- PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 60% 0.19 (0.13-0.26) 60 57% 55% PFS, % 50 40 7 new PFS 30 events occurred between 5 and 7 20 15% 10% 10% years with 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 — 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 - At the time of this analysis, median PFS by investigator was still not reached with lorlatinib CI, confidence interval; HR, hazard ratio; ITT, intention to treat; NR, not reached; PFS, progression-free survival 2026 ASCO PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF #ASCO26 CURICAL OHCOLOGE ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse; contact permissions@asco.org. KNOWLEDGE CONQUERS CANCER
Christine A. Garcia, MD, MPH
#ASCO26 · May 29, 2026
View Post
2026A ANNUAL N 2026ASCO ANNUAL MEETING 1 ASCO ASCO ASO ASCO ASCO ASCO --- PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Loriatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS. median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PFS, - 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% 10% 10% years with 10 % 7% 3% forlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) - Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib a confidence information HI, have nation nimber for frood, NNL - marched RS progression Income survival 2026 ASCO #ASCO26 - Tony 5. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO WREN I ANNUAL MEETING Presentation - Permission - - - - Commission CANCER --- Estimated Proportion of PFS Events With Lorlatinib Conditional PFS beyond 2 years PFS Measure estimate Estimated proportion of PFS events 100 PFS at 2 years 70% PFS at 7 years 55% 90 *Conditional 80 79% 70% PFS (7Y/2Y) 20% 70 "Estimated as the ratio of the 10% 55% Kaplan-Meier PFS estimates at 7 60 5% and 2 years: (55% / 70%) 2% PFS, % 3% 50 3% 2% 40 30 20 10 0 Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 No. at risk Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Patients without a PFS event in the first 24 months on lorlatinib have a 79%* probability of remaining alive and progression-free at 7 years PFS, progression-free survival 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF CUNICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asco.org KNOWLEDGE CONQUERS CANCER
Hidehito HORINOUCHI
Hidehito HORINOUCHI @HHorinouchi
#ASCO26 · May 29, 2026
View Post
PFS in the ITT Population (7-Year Follow-Up) 20 The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 AN months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) Events, n 62 119 90 PFS, median NR 9.1 80 (95% CI), months (68.5-NR) (7.4-10.9) 70% 65% HR (95% CI) 0.19 (0.13-0.26) 70 63% 60% 57% 55% 60 PFS, % 50 7 new PFS 40 events occurred between 5 and 7 30 years with 15% 10% lorlatinib: 4 20 10% 8% 7% 3% progression 10 events and 3 56 60 64 68 72 76 80 84 88 92 96 100 0 24 28 32 36 40 44 48 52 deaths (not 0 4 8 12 16 20 treatment related) Months No. Lorlatinib at risk 149 126 118 111 103 96 93 89 16 87 11 81 10 81 9 79 9 78 9 75 8 73 8 71 7 69 6 68 6 66 6 65 5 62 2 38 2 28 0 9 0 0 2 0 0 Crizotinib At 147 the 107 time 70 42 of 30 this 19 analysis, 16 median PFS free survival by investigator was still not reached with lorlatinib CI, confidence interval; HR, hazard ratio, ITT, intention to treat, NR, not reached, PFS, progression ASCO - CIRCA - KNOWLEDGE CONQUERS CANCER BY: Tony S.K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO #ASCO26 PRE Presentation SENTED is property of the aufhor and ASCO Permission required for reuse, contact permissions@asco org ENAL MEETING 2026ASCO ASCO ANNUAL MEETING ASCO ASCO CO --- Time to IC Progression by Brain Metastases With baseline brain metastases Without baseline brain metastases Lorlatinib Crizotinib Lorlatinib Crizotinib (n=35) (n=38) (n=114) (n=109) Events, n 5 26 Events, n 4 40 Time to IC progression, NR 7.2 Time to IC progression, NR 23.9 months, median (95% CI) (NR-NR) (3.7-11.0) months, median (95% CI) (NR-NR) (16.4-30.8) HR (95% CI) 0.03 (0.01-0.13) HR (95% CI) 0.04 (0.02-0.12) 96% 96% 96% 96% 96% 96% 100 100 90% 90 83% 83% 83% 83% 83% 90 Patients without IC progression, % 80 Patients without IC progression, % 80 70 70 60 60 50 50 40 40 30 30 49% 33% 33% 20 29% 20 29% 10 22% 10 0 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96100 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 Months No. at risk Months No. at risk Lorlatinib 35 32 29 28 28 26 26 25 22 22 20 20 20 20 20 20 18 18 18 18 17 11 7 3 1 0 - Lorlatinib 114 96 90 84 77 72 70 67 67 64 64 61 61 60 58 56 54 51 51 50 47 30 22 6 1 0 Crizotinib 38 21 12 5 3 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 - Crizotinib 109 86 63 41 31 21 19 18 12 10 10 10 9 8 8 7 6 6 6 5 2 2 0 0 0 0 Sustained plateau in time to IC progression indicates a prolonged protective effect against the development of new brain metastases and a sustained control of the existing ones CI, confidence interval; HR, hazard ratio; IC, intracranial; NR, not reached PRE SENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN ONCE 6 ASCO #ASCO26 KNOWLEDGE CONQUERS CANCER Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asco.org JAL MEETING 2026ASCO ANNUAL MEETING ASCO --- Baseline Lorlatinib ctDNA Genetic Alterations in EP and LTR With 10 Early progressors (EP; n=22) Long-term responders (LTR; n=30) 5 0 59% ALK 57% 59% ALK EML4 53% 60% EML4 TP53 17% 23% TP53 ATM 10% Early progressors had a higher median number 18% ATM ZFHX3 3% 18% ZFHX3 CHEK2 of altered genes (10 VS 6) and a higher median 0% CHEK2 14% NOTCH3 7% NOTCH3 14% blood-based tumor mutation burden (7.7 VS 5.1) NTRK3 0% NTRK3 14% ARID1A 10% ARID1A compared with long-term responders 14% NF1 0% NF1 14% KRAS 0% KRAS 14% TP53 mutations were observed in 50% of MYC 0% MYC 9% CIC 3% CIC 9% SPEN samples from early progressors compared with 7% SPEN 9% APC 3% APC 17% in long-term responders 9% MTOR 3% MTOR 9% PREX2 7% PREX2 9% KDM5C 3% KDM5C 9% PCDH15 3% PCDH15 Alterations 9% ROS1 3% ROS1 Treatment Early progressors are patients who had PFS 9% 3% TET1 SNV TET1 Lorlatinib Indel events within 12 months of the start of the study 9% ARID2 3% ARID2 3% ATRX CNA focal amp 9% ATRX Fusion PFS status Long-term responders are patients who were PDGFRA 3% PDGFRA 9% Early alive with no documented progression at 84 9% DICER1 3% DICER1 Late months. 9% BRIP1 3% BRIP1 9% IGR 13% IGR ROBO2 ROB02 5% 10% 5% CDC73 7% CDC73 BRCA1 7% BRCA1 Early progressors had a higher number of 5% 5% PBRM1 7% PBRM1 DNMT3B 10% DNMT38 alterations and a higher tumor mutation 0% SETD2 0% SETD2 10% Treatment Treatment burden compared with long-term PFS status PFS status responders EP, early progressor, LTR, long term responder, PFS, progression free survival 6 ASCO PRE SENTED BY: Tony S.K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO INDICAL 10000000 CINCA - #ASCO26 KNOWLEDGE CONQUERS CANCER JAL MEETING Presentation is property of the author and ASCO. Permission required for reuse, contact permissions@aso.org. 2026ASCO ANNUAL MEETING ASSO --- Key Takeaway Point/Conclusion Results from this 7-year analysis show that lorlatinib as a single agent is able to persistently control the disease, both systemically and intracranially, over the entire duration of treatment and has the potential to transform advanced ALK-positive NSCLC into a chronic condition for a substantial proportion of patients ALK, anaplastic ymphoma kinase; NSCLC, non-small cell lung cancer ASCO AND SOCIETY CIRICAL INCOLOGIA KNOWLEDGE CONQUERS CANCER SENTED BY: Tony S.K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO #ASCO26 PRE Presentation is property of the author and ASCO. Permission required for reuse, contact permissions@asco.org TRAL MEETING 2026ASCO ANNUAL MEETING ASCO ASCO ASCO CO
Uğur Özkerim
Uğur Özkerim @UOzkerim
#ASCO26 · May 29, 2026
View Post
PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PFS, % 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% years with 10% 10% 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months treatment related) No. at risk Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib CI, confidence interval; HR, hazard ratio; ITT, intention to treat; NR, not reached; PFS, progression-free survival. 2026 ASCO PRE SENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF CUNICAL ONCOLOGY #ASCO26 ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asoo.org KNOWLEDGE CONQUERS CANCER
José Márcio Barros de Figueiredo MD, MSc
#ASCO26 · May 29, 2026
View Post
PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PFS, % 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% years with 10% 10% 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) - Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib CI, confidence interval, HR, hazard ratio; III, intention to troat; NR, not reached, PFS, progression froo survival 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN OCEN OF CLINCIN CHICOLOGY ANNUAL MEETING Presentation a property of the author and ASCO. Permission required for reuse, contact permissions@usco.org ENOWLEDOE CONQUERS CANCER
Dr. Antonio Calles 🫁🚭
#ASCO26 · May 29, 2026
View Post
Time to IC Progression by Brain Metastases With baseline brain metastases Without baseline brain metastases Lorlatinib Crizotinib Lorlatinib Crizotinib (n=35) (n=38) (n=114) (n=109) Events, n 5 26 Events, n 4 40 Time to IC progression, NR 7.2 Time to IC progression, NR 23.9 months, median (95% CI) (NR-NR) (3.7-11.0) months, median (95% CI) (NR-NR) (16.4-30.8) HR (95% CI) 0.03 (0.01-0.13) HR (95% CI) 0.04 (0.02-0.12) 96% 96% 96% 96% 96% 96% 100 100 90% 90 83% 83% 83% 83% 83% 90 at Patients without IC progression, % 80 Patients without IC progression, % 80 70 70 60 60 50 50 40 40 30 30 49% 33% 20 33% 20 29% 10 29% 10 22% 0 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 No. risk Months No. at risk Months Loriatinib 35 32 29 28 28 26 26 25 22 22 20 20 20 20 20 20 18 18 18 18 17 11 7 3 1 0 Lorlatinib 114 96 90 84 77 72 70 67 67 64 64 61 61 60 58 56 54 51 51 50 47 30 22 6 1 0 Crizotinib 38 21 12 5 3 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Crizotinib 109 86 63 41 31 21 19 18 12 10 10 10 9 8 8 7 6 6 6 5 2 2 0 0 0 0 Sustained plateau in time to IC progression indicates a prolonged protective effect against the development of new brain metastases and a sustained control of the existing ones CI, confidence interval; HR, hazard ratio; IC, intracranial; NR, not reached. 2026 ASCO PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) #ASCO26 ASCO AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO. Permission required for reuse; contact permissions@asco.org KNOWLEDGE CONQUERS CANCER
Marcelo Corassa, MD.
Marcelo Corassa, MD. @MarceloCorassa
#ASCO26 · May 29, 2026
View Post
Background & Methods CROWN (NCT03052608): A Randomized, Global, Phase 3 Study Lorlatinib is a preferred standard-of-care first-line therapy for Key eligibility criteria Lorlatinib 100 mg once daily Stage IIIB/IV ALK+ NSCLC patients with advanced ALK-positive NSCLC No prior systemic treatment for Stratified by: metastatic disease Presence of brain metastases (yes vs no) Randomized Ethnicity (Asian vs non-Asian) At 5 years of follow-up, median PFS by investigator was not ECOG performance status 0-2 1:1 reached with lorlatinib vs 9.1 months with crizotinib Asymptomatic treated or untreated CNS Crizotinib 250 mg twice daily metastases were permitted >1 extracranial measurable target lesion No crossover between treatment arms was permitted (RECIST 1.1) with no prior radiation We report long-term outcomes from the phase 3 CROWN required Primary endpoint: PFS by BICR proor Secondary endpoints: overall survival (key secondary endpoint), study after 7 years of follow-up PFS by investigator, objective response, IC objective response, IC time to progression, DOR, IC DOR, safety, and biomarker analyses Results Median PFS was still not reached with lorlatinib and Time to IC progression was still not reached with lorlatinib and 16.4 months with In the lorlatinib arm, no emerging new ALK resistance mutations 9.1 months with crizotinib after ~7 years of follow-up crizotinib; no new IC progression events occurred after the first 30 months were detected in the ctDNA samples at end of treatment HR (95% CI): 0.19 (0.13-0.26) HR (95% CI): 0.06 (0.03-0.12) 100 100 94% 92% 92% 92% 92% 92% 90 90 The safety profile of lorlatinib was similar to that reported in the 80 80 primary analysis of the CROWN study and in subsequent follow- 70% 65% up analyses 70 63% 70 60% 60 57% 55% PFS,% 40 30 Patients without progression, 60 The most common any-grade all-causality AEs were 50 50 hypercholesterolemia (73%), hypertriglyceridemia (71%), and edema (58%) 40 30 There was no increase in the frequency of patients with 37% 20 15% 20 25% 25% maximum grade 3 or 4 AEs since the 5-year analysis (77%) Lorlatinib 10% 10% 10 8% Lorlatinib 22% 7% 3% 22% Crizotinib 10 16% Crizotinib No new treatment-related AEs led to treatment 0 0 discontinuation after the first 26 months 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 Months Months AE, adverse event; ALK, anaplastic lymphoma kinase; BICR, blinded independent central review; CNS, central nervous system; ctDNA, circulating tumor DNA; DOR, duration of response; ECOG, Eastern Cooperative Oncology Group; IC, intracranial; NSCLC, non-small cell lung cancer; PFS, progression- free survival. Results from this 7-year analysis show that lorlatinib as a single agent is able to persistently control the disease, over the entire duration of treatment and has the potential to transform advanced ALK-positive NSCLC into a chronic disease for a substantial proportion of patients
Stephen V Liu, MD
Stephen V Liu, MD @StephenVLiu
#ASCO26 · May 29, 2026
View Post
Efficacy in Patients With and Without Dose Reduction Within 26 Weeks PFS Time to IC progression With dose reduction Without dose reduction With dose reduction Without dose reduction (n=23) (n=98) (n=24) (n=99) Events, n 6 36 Events, n 0 6 PFS, Time to IC progression, NR NR NR NR months, median months, median (95% CI) (NR-NR) (NR-NR) (79.8-NR) (81.9-NR) 100 (95% CI) 100 90 90 80 80 70 PFS, % Patients without IC 70 60 progression, % 60 50 50 40 40 30 30 20 20 10 10 0 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 No. at risk Months No. at risk Months With dose 23 21 20 18 17 15 15 15 14 13 12 12 12 12 11 11 10 10 9 7 5 3 0 0 0 0 — With dose 24 21 20 18 17 15 15 15 14 13 13 13 13 13 11 11 11 11 10 8 5 3 0 0 0 0 reduction reduction -- Without 98 96 86 79 76 75 72 70 67 66 66 64 61 60 59 57 56 55 55 37 24 12 5 2 0 0 -- Without 99 96 88 82 79 78 75 73 70 68 68 67 66 64 63 58 58 57 57 39 25 12 5 2 0 0 dose dose reduction reduction Long-term efficacy with lorlatinib was similar between patients with and without dose reduction within 26 weeks. PFS and IC TTP were also consistent across lorlatinib dose levels (100, 75, or 50 mg) CI, confidence interval; IC, intracranial; NR, not reached, PFS, progression-free survival 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asco.org KNOWLEDGE CONQUERS CANCER --- Conclusions After 7 years of follow-up in the phase 3 CROWN study, with lorlatinib treatment: PFS exceeds 7 years with 7-year PFS of 55% Patients without progression within 24 months on lorlatinib had a 79% probability of being alive and free of progression at 7 years PFS benefit was consistent across all prespecified subgroups 7-year IC time to progression was 92%, with a sustained plateau from 30 months onward, indicating long-term CNS protection OS follow-up is ongoing and results will be presented in the future No new safety signals were identified, and all treatment-related discontinuations occurred within the first 26 months ctDNA analysis showed no emerging new ALK resistance mutations Early progressors had a higher number of alterations and a higher tumor mutation burden compared with long-term responders ALK, anaplastic lymphoma kinase; CNS, central nervous system, ctDNA circulating tumor DNA IC, intracranial OS, overall survival PFS, progression-free survival 2026 ASCO PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF #ASCO26 CUNICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asco.org KNOWLEDGE CONQUERS CANCER
Oriol Mirallas MD
Oriol Mirallas MD @DrMirallas
#ASCO26 · May 29, 2026
View Post
SCO MEETING Lorlatinib: Mechanism of Action Lorlatinib is a highly potent third-generation ALK Molecular structure of ofatinib TKI, specifically developed to penetrate the Macrocycle compound) blood-brain barrier and is retained in the CNS at 0 the therapeutic levels¹² F. N it is known to have broad activity against most known ALK resistance mutations¹² N in addition, orlatinib has shown in viro activity N 0 against ROS1 and NTRK mutations H2N N N -- . a ASCO MASCOON - - ASCO - --- CROWN: A Randomized, Global, Phase 3 Study Primary endpoint Lorlatinib 100 mg once daily Key eligibility criteria n=149 PFS by BICR Key secondary endpoint Stage IIIB/IV ALK+ NSCLC OS No prior systemic treatment for Stratified by: Presence of brain metastases Other secondary endpoints metastatic disease ECOG PS 0-2 (yes vs no) PFS by investigator Randomized Ethnicity ORR by BICR and investigator Asymptomatic treated or untreated 1:1 (Asian vs non-Asian) №296 IC ORR, IC TTP, DOR, IC DOR, CNS metastases were permitted TTR and IC TTR by BICR and 21 extracranial measurable target Crizotinib 250 mg twice daily investigator lesion (RECIST 1.1) with no prior n=147 Safety radiation required Quality of life No crossover between treatment arms was permitted Biomarker analyses In this post hoc analysis with 7 years of follow-up, we present investigator-assessed efficacy outcomes, safety, and biomarker analyses (data cutoff: October 31, 2025) At data cutoff, the required number of OS events for a protocol-specified second interim analysis (at least 139 deaths) has not been reached; 123 of 296 (42%) discontinued the study in both arms due to death ALK, anaplastic lymphoma knase, BICR, blinded independent central review, CNS central nervous system DOR duration of response, ECOG. Eastem Cooperative Oncology Group HR, hazard ratio, IC, intracranal, NSCLC, non- small cell lung cancer, ORR, objective response rate, OS, overall survival, PFS, progression-tree survival, PS. performance status; RECIST, Response Evaluation Criteria in Solid Tumors TIP, time to the progression; TTR, time in under response. Defined as the time from randomization to RECIST defined progression or death due to any cause. 2026 ASCO PRE SENTED IT: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO - CANCA #ASCO26 ANNUAL MEETING Presentation . property of the author and ASCO Permission required for - contact permissions@aste.com ENQUILED CONQUERS CANCER 2026ASCO ANNUAL MEETING SCO ASCO ASCO ASCO ASCO ASCO ASCO ASCO CO ASCO --- PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinlb 100 (n=149) (n=147) 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PFS, % 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% 10% 10% years with 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib Cl, confidence interval; HR, hazard ratio; U. intention to treat; NR, not reached; PFS, progression-free survival. 2026 ASCO PRE SENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk). #ASCO26 ASCO AMERICAN SOCIETY OF CLINICAL CHICOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse; contact permissions@asco.org KNOWLEDGE CONQUERS CANCER --- Adverse Events AEs of special interest Lorlatinib Crizotinib 58% Edema 43% No increase in frequency of grade 3 or 4 AEs since the 5-year analysis (77%) 71% Hypertnglycoridomia® 6% - Majority were due to an increase in lipid values 73% Hypercholosterotemia® 4% Despite higher rates of hyperlipidemia with lorlatinib, no increase in cardiovascular AEs was 46% Peripheral neuropathy 16% observed compared with crizotinib 45% Weight gain 13% Frequency of CNS AEs was consistent with longer 30% Cognitive offects 7% follow-up; most were grade 1 or 2 Dose reductions were reported in 34% of patients 21% Mood effects 7% in the lorlatinib group; median time to dose 5% Psychotic offects 1% reduction was 25 weeks Grade 1/2 All treatment-related discontinuations (5%) 6% Speech offects 0% Grade 1/2 Grade 3/4 Grade 3/4 occurred within the first 26 months 100 80 60 40 20 0 0 20 40 60 80 100 Incidence, % Incidence, % Safety profile of lorlatinib was consistent with prior AE, adverse event; CNS, central nervous system. analyses with no new safety signals with longer follow-up Comprised 0 cluster of AEs that may represent similar clinical symptoms or syndromos. 2026 ASCO PRE SENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) #ASCO26 ASCO AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asco org. KNOWLEDGE CONQUERS CANCER
David Heredia.
David Heredia. @HerediaOncologo
#ASCO26 · May 29, 2026
View Post
PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 2026ASCO ANNUAL MEETING 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 0.19 (0.13-0.26) 60% 60 57% 55% PFS, % 50 40 7 new PFS events occurred 30 between 5 and 7 20 15% years with 10% 10% 8% 10 7% 3% lorlatinib: 4 progression 0 events and 3 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) — Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib CL confidence interval HR hazard ratio, 111. intention to treat, NR not reached PFS, progression free survival 2026 ASCO #ASCO26 PRESENTED BY ST. Tony S.K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO - CORREAL ANNUAL MEETING Presentation property the author and ASCO Permission required for - contact permissions@asco.org KNOWLEDGE CONQUERS CANCER Γ 2026 ASCO J ANNUAL MEETING --- Time to IC Progression in the ITT Population Lorlatinib Crizotinib 100 94% 92% 92% 92% 92% 92% (n=149) (n=147) 2026ASCO 90 ANNUAL MEETING Events, n 9 66 Patients without IC progression, % 80 Time to IC NR 16.4 70 progression, (NR-NR) (12.7-21.9) 60 months, median 50 (95% CI) 40 HR (95% CI) 0.06 (0.03-0.12) 30 37% 20 25% 25% 22% 10 22% 16% Tumor assessments, including brain 0 MRI, have been performed every 8 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 weeks up to 5 years and every 16 No. at risk Months weeks afterwards in all patients - Lorlatinib 149 128 119 112 105 98 96 92 89 86 84 81 81 78 78 76 72 69 69 68 64 41 29 9 2 — Crizotinib 147 107 75 46 34 22 19 18 12 12 10 10 9 8 8 7 6 6 6 5 2 2 0 0 0 throughout the study No new IC progression events occurred after the first 30 months on lorlatinib CI, confidence interval HR, hazard ratio, IC intracranial ITT. intention to treat MRI, magnetic resonance maging NR, not reached 2026 ASCO #ASCO26 PRE MNITORY Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO CURRENT ORCOLOGY ANNUAL MEETING Presentation . property of the author and ASCO Permission required for - contact permissione@asco.org KNOWLEDGE CONQUERS CANCER 2026 ASC ANNUAL MEET
Dr Riyaz Shah
Dr Riyaz Shah @DrRiyazShah
#ASCO26 · May 29, 2026
View Post
CROWN: A Randomized, Global, Phase 3 Study Primary endpoint Lorlatinib 100 mg once daily Key eligibility criteria n=149 PFS by BICR Stage IIIB/IV ALK+ NSCLC Key secondary endpoint No prior systemic treatment for OS Stratified by: metastatic disease Presence of brain metastases Other secondary endpoints ECOG PS 0-2 Randomized (yes vs no) PFS by investigator Asymptomatic treated or untreated 1:1 Ethnicity ORR by BICR and investigator CNS metastases were permitted N=296 (Asian vs non-Asian) IC ORR, IC TTP, DOR, IC DOR, TTR and IC TTR by BICR and ≥1 extracranial measurable target Crizotinib 250 mg twice daily investigator lesion (RECIST 1.1) with no prior radiation required n=147 Safety Quality of life No crossover between treatment arms was permitted Biomarker analyses In this post hoc analysis with 7 years of follow-up, we present investigator-assessed efficacy outcomes, safety, and biomarker analyses (data cutoff: October 31, 2025) At data cutoff, the required number of OS events for a protocol-specified second interim analysis (at least 139 deaths) has not been reached; 123 of 296 (42%) discontinued the study in both arms due to death ALK, anaplastic ymphoma kinase; BICR, blinded independent central review; CNS, central nervous system; DOR, duration of response; ECOG, Eastern Cooperative Oncology Group; HR, hazard ratio; IC, intracranial; NSCLC, non-small cell lung cancer; ORR, objective response rate; OS, overall survival; PFS, progression-free survival; PS, performance status; RECIST, Response Evaluation Criteria in Solid Tumors; TTP, time to tumor progression; TTR, time to tumor response. *Defined as the time from randomization to RECIST-defined progression or death due to any cause. 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ANNUAL MEETING ASCO AMERICAN SOCIETY OF Presentation is property of the author and ASCO. Permission required for reuse, contact permissions@asco.org. CUNICAL ONCOLOGY KNOWLEDGE CONQUERS CANCER --- PFS in the ITT Population (7-Year Follow-Up) The median duration of follow-up for PFS was 83.0 months (95% CI, 81.2-86.3) in the lorlatinib arm and 77.2 months (95% CI, 36.8-not evaluable) in the crizotinib arm Lorlatinib Crizotinib 100 (n=149) (n=147) 90 Events, n 62 119 PFS, median NR 9.1 80 70% (95% CI), months (68.5-NR) (7.4-10.9) 70 65% 63% HR (95% CI) 60% 0.19 (0.13-0.26) 60 57% 55% PFS, % 50 40 7 new PFS 30 events occurred between 5 and 7 20 15% 10% 10% years with 8% 10 7% 3% lorlatinib: 4 0 progression 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 events and 3 80 84 88 92 96 100 deaths (not Months No. at risk treatment related) - Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 - Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 8 7 6 6 6 5 2 2 0 0 0 0 At the time of this analysis, median PFS by investigator was still not reached with lorlatinib CI, confidence interval; HR, hazard ratio; U. intention to treat; NR, not reached; PFS, progression-free survival 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF CUNICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO. Permission required for reuse; contact permissions@asco.org KNOWLEDGE CONQUERS CANCER --- Estimated Proportion of PFS Events With Lorlatinib Conditional PFS beyond 2 years PFS Measure estimate Estimated proportion of PFS events PFS at 2 years 70% 100 PFS at 7 years 55% 90 *Conditional 79% 80 70% PFS (7Y/2Y) 20% 70 *Estimated as the ratio of the 10% 55% Kaplan-Meier PFS estimates at 7 60 and 2 years: (55% / 70%) 5% 2% 3% PFS, % 3% 50 2% 40 30 20 10 0 Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 No. at risk — Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 78 75 73 71 69 68 66 65 62 38 28 9 2 0 Patients without a PFS event in the first 24 months on lorlatinib have a 79%* probability of remaining alive and progression-free at 7 years PFS, progression-free survival. 2026 ASCO PRE SENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) #ASCO26 ASCO AMERICAN SOCIETY or CUPICAL CHICOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission required for reuse, contact permissions@asco.org. KNOWLEDGE CONQUERS CANCER --- Time to IC Progression in the ITT Population Lorlatinib Crizotinib 100 94% 92% 92% 92% 92% 92% (n=149) (n=147) 90 Events, n 9 66 Patients without IC progression, % 80 Time to IC NR 16.4 70 progression, (NR-NR) (12.7-21.9) 60 months, median (95% CI) 50 HR (95% CI) 0.06 (0.03-0.12) 40 30 37% 20 25% 25% 22% 22% 10 16% Tumor assessments, including brain 0 MRI, have been performed every 8 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 84 88 92 96 weeks up to 5 years and every 16 No. at risk Months weeks afterwards in all patients — Lorlatinib 149 128 119 112 105 98 96 92 89 86 84 81 81 78 78 76 72 69 69 68 64 41 29 9 2 — Crizotinib 147 107 75 46 34 22 19 18 12 12 10 10 9 8 8 7 6 6 6 5 2 2 0 0 0 throughout the study No new IC progression events occurred after the first 30 months on lorlatinib CI, confidence interval; HR, hazard ratio; IC, intracranial; ITT, intention to treat; MRI, magnetic resonance imaging; NR, not reached 2026 ASCO #ASCO26 PRESENTED BY: Tony S. K. Mok, MD (tony@clo.cuhk.edu.hk) ASCO AMERICAN SOCIETY OF DUPICAL CHCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO. Permission required for reuse, contact permissions@asco.org KNOWLEDGE CONQUERS CANCER
Paolo Tarantino
Paolo Tarantino @PTarantinoMD
#ASCO24 · May 31, 2024
View Post
100 Lorlatinib (n = 149) Crizotinib (n = 147) 90 Events, n 55 115 PFS, months, median NR (64.3 to NR) 9.1 (7.4 to 10.9) (95% CI) 80 HR (95% CI) 0.19 (0.13 to 0.27) 70 70% 60 65% 63% PFS (%) 60% 50 40 30 15% 20 10% 10% 8% 10 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 Time (months) Number at risk Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 77 74 67 45 26 14 4 1 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 6 4 2 0 0 0 0
Marcelo Corassa, MD.
Marcelo Corassa, MD. @MarceloCorassa
#ASCO24 · May 31, 2024
View Post
100 Lorlatinib (n = 149) Crizotinib (n = 147) 90 Events, n 55 115 PFS, months, median NR (64.3 to NR) 9.1 (7.4 to 10.9) (95% CI) 80 HR (95% CI) 0.19 (0.13 to 0.27) 70 70% 60 65% 63% PFS (%) 60% 50 40 30 15% 20 10% 10% 8% 10 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 Time (months) Number at risk Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 77 74 67 45 26 14 4 1 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 6 4 2 0 0 0 0
Nathan A. Pennell MD, PhD, FASCO
#ASCO24 · May 31, 2024
View Post
100 Lorlatinib (n = 149) Crizotinib (n = 147) 90 Events, n 55 115 PFS, months, median NR (64.3 to NR) 9.1 (7.4 to 10.9) (95% CI) 80 HR (95% CI) 0.19 (0.13 to 0.27) 70 70% 60 65% 63% PFS (%) 60% 50 40 30 15% 20 10% 10% 8% 10 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 Time (months) Number at risk Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 77 74 67 45 26 14 4 1 0 Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 6 4 2 0 0 0 0
Charu Aggarwal, MD, MPH, FASCO
#ASCO24 · May 31, 2024
View Post
At 60.2 Months of Median Follow-Up, Median PFS by Investigator Was Still Not Reached With Lorlatinib 100 Lorlatinib Crizotinib 90 (n=149) (n=147) 80 Events, n 55 115 TO PFS, median NR 9.1 60 (95% CI), (64.3-NR) (7.4-10.9) PFS, % 50 months 40 HR (95% CI) 0.19 (0.13-0.27) 30 20 10 0 0 4 6 12 16 20 24 28 32 36 40 44 48 52 50 00 64 68 72 78 50 No. at risk Time, months - Lorialinib 149 120 116 111 103 96 93 89 87 61 61 79 77 74 67 45 26 14 4 1 0 - Crizotinib 147 107 70 42 30 19 16 10 11 10 9 0 9 a 6 4 2 0 0 0 0 HR, - - MR, - insulanc) 05, - - FEE - - 2024 ASCO #ASCO24 - - Benjamin J. Belomon ASCO - | ANIMALLAS MEETING - - - - - - o - CONDITIONS
Yakup Ergün
Yakup Ergün @dr_yakupergun
#ASCO24 · May 31, 2024
View Post
[Slide 1] Lorlatinib Showed Superior PFS Benefit Irrespective of Presence or Absence of Baseline Brain Metastases With Baseline Brain Metastases Without Baseline Brain Metastases Lorlatinib Crizotinib Lorlatinib Crizotinib (n=35) (n=38) (n=114) (n=109) Events n 16 34 Events, n 39 81 100 PFS, median NR 6.0 100 PFS, median NR 10.8 (95% CI). months (32.9-NR) (3.7-7.6) (95% CI). months (64.3-NR) (9.0-12.8) 90 90 HR (95% CI) 0.08 (0.04-0.19) HR (95% CI) 0.24 (0.16-0.36) 80 80 70 70 63% 60 53% 60 50 50 40 40 30 30 20 20 10% 10 10 0 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 No. at risk Time, months Time, months No. at risk Lorlatinib 35 31 29 28 28 26 26 25 23 20 20 20 19 18 15 10 7 5 2 0 - Lorlatinib 114 95 89 83 75 70 67 64 64 61 61 59 58 56 52 35 19 9 2 1 0 Crizotinib 38 22 11 4 3 1 0 0 0 0 - Crizotinib 109 85 59 38 27 18 16 16 11 10 9 9 9 8 6 4 2 0 0 HR. hazard ratio; NR. not reached; PFS, progression-free survival 2024 ASCO #ASCO24 PRESENTED BY: Benjamin J. Solomon (Ben.Solomon@petermac.org) ASCO AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING Presentation is property of the author and ASCO Permission KNOWLEDGE CONQUERS CANCER
Benjamin Besse
Benjamin Besse @BenjaminBesseMD
#ASCO24 · Jun 1, 2024
View Post
Current Post Hoc Analyses at 5 Years Endpoint evaluation by BICR stopped after the 3-year analysis Lorlatinib 100 mg once daily Current analyses Key eligibility criteria n=149 Data cutoff: October 31, 2023 Stage IIIB/IV ALK+ NSCLC No prior systemic treatment for Stratified by: metastatic disease Presence of brain metastases Investigator Assessed ECOG PS 0-2 Randomized (yes VS no) PFS' Asymptomatic treated or untreated 1:1 Ethnicity ORR and IC ORR CNS metastases were permitted N=296 (Asian vs non-Asian) DOR and IC DOR 21 extracranial measurable target lesion (RECIST 1.1) with no prior Crizotinib 250 mg twice daily IC TTP radiation required n=147 Safety No crossover between treatment arms was permitted Biomarker analyses The median duration of follow-up for PFS was 60.2 months (95% CI, 57.4-61.6) in the lorlatinib arm and 55.1 months (95% CI, 36.8-62.5) in the crizotinib arm CNS, central nervous system; DOR, duration of response ECOG, Eastern Cooperative Oncology Group IC, intracranial, ORR, objective response rate NSCLC, non small cell kng cancer, PFS. progression that survival, PS performance - RECIST, Response Evaluation Criteria in Solid Tumors, TTP, time to tumor progression. Defined as the time from randomization to RECIST-defined progression or death due to any cause 2024 ASCO #ASCO24 PRE SENTED BY: Benjamin J. Solomon (Ben.Solomon@petermac.org ASCO - seceive GREA I ANNUAL MEETING Presentation is property of N author ed ASCO Permission required for - contact KNOWLEDGE CONDUCES CANCER --- At 60.2 Months of Median Follow-Up, Median PFS by Investigator Was Still Not Reached With Lorlatinib 100 Lorlatinib Crizotinib 90 (n=149) (n=147) 80 Events, n 55 115 70 PFS, median NR 9.1 60 (95% CI), (64.3-NR) (7.4-10.9) FS, % 50 months 40 HR (95% CI) 0.19 (0.13-0.27) 30 20 10 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80 No. at risk Time, months - Lorlatinib 149 126 118 111 103 96 93 89 87 81 81 79 77 74 67 45 26 14 4 1 0 - Crizotinib 147 107 70 42 30 19 16 16 11 10 9 9 9 8 6 4 2 0 0 0 0 HR, hazard ratio, NR, not reached, os, overall survival, PFS, progression-free survival 2024 ASCO #ASCO24 PRESENTED IT Benjamin J. Solomon (Ben.Solomon@petermac.org) ASCO ONE INCOUDING ANNUAL MEETING Presentation is property of the author and ASICO Permission required for - contact permissions) KNOWLEDGE CONDUERS CANCELL

Top Tweets

Normand Blais, MD 🌻
Normand Blais, MD 🌻 @NormandBlais
No matter what @VPrasadMDMPH may say, these results are outstanding and never seen before in lung cancer, ever!
22,867 views 2 likes 0 RT 2024-05-31
Paolo Tarantino
Paolo Tarantino @PTarantinoMD
Truck test ✅ #CROWN #lcsm https://t.co/IHvSnJS6Z5 https://t.co/hS6f7pYRpJ
21,119 views 152 likes 21 RT 2024-05-31
Marcelo Corassa, MD.
Marcelo Corassa, MD. @MarceloCorassa
So, 5y PFS is out. CROWN shows that only 3% of patients had disease progression from year 4 to year 5. Toxic, Lorlatinib is indeed, but this in totally unprecedented in thoracic oncology. ALK fusion patients leading the way into making NSCLC a chronic disease #ASCO24 https://t.co/wb77jD5P0U
19,779 views 87 likes 27 RT 2024-05-31
gilberto lopes
gilberto lopes @glopesmd
Remarkable is an understatement! #ASCO26 7-yr update (Abstract 8502, CROWN): 1L lorlatinib in advanced ALK+ NSCLC — median PFS STILL not reached at 7 years, the longest ever in advanced NSCLC. 7-yr PFS 55% vs 3% for crizotinib. Clear 24 mo and you have a 79% chance of being PFS https://t.co/FdjyMSzkIi
17,559 views 68 likes 24 RT 2026-05-22
Charu Aggarwal, MD, MPH, FASCO
Charu Aggarwal, MD, MPH, FASCO @CharuAggarwalMD
Let’s take a minute. Have we seen anything like this in NSCLC before? mPFS NR at 5 years? 👏🏽👏🏽👏🏽👏🏽 These curves are very impressive, and should urge us to think about management of AEs and optimize 1L Tx for ALK+ NSCLC @ASCO #ASCO24 @ALKPositiveinc @OncoAlert @bensolomon1 https://t.co/TYKMjDWWbQ
17,512 views 84 likes 24 RT 2024-05-31
Laura Alder, MD
Laura Alder, MD @lauraaldermd
🧵 CROWN 7-Year Update: Lorlatinib in 1L ALK+ NSCLC: the longest PFS ever reported in advanced NSCLC keeps getting longer!!! #ASCO26 🫁 Abstracts! Presenter: @TonyMok9 Key takeaways: 👇 @ALKPositiveinc 1) 1/ 📈 Median PFS STILL not reached at 7 years. • 7-yr PFS rate: 55% https://t.co/SoInsv7wwc
16,261 views 119 likes 42 RT 2026-05-21
Nathan A. Pennell MD, PhD, FASCO
Nathan A. Pennell MD, PhD, FASCO @n8pennell
Not to steal the thunder from the oral session today, but this is the CROWN PFS curve, more or less flat between 2-5 years and still 60% progression free at 5 years! #ASCO24 #LCSM Is it worth the side effects of lorlatinib to turn ALK+ NSCLC into CML? https://t.co/Sw4uN8XGW2 https://t.co/NFTEaDaNPl
15,482 views 56 likes 15 RT 2024-05-31
Vinay Prasad MD MPH
Vinay Prasad MD MPH @VPrasadMDMPH
Its great to see #asco24 changing language. In the future, I would love to see @asco make sure All randomized studies use appropriate control arms (sorry CROWN) All RCTs provide appropriate post protocol care (sorry ADAURA) These choices shorten lives so PIs can claim a win https://t.co/bc23J93C4e
12,927 views 25 likes 2 RT 2024-05-31
Charu Aggarwal, MD, MPH, FASCO
Charu Aggarwal, MD, MPH, FASCO @CharuAggarwalMD
The curve again! 👑 #ASCO24 @ASCO https://t.co/PlDA2tfpvQ https://t.co/kgQ1ry4eeN
11,949 views 95 likes 21 RT 2024-05-31
Yakup Ergün
Yakup Ergün @dr_yakupergun
#ASCO24 CROWN study: lorlatinib vs crizotinib Lorlatinib..... no need to comment, look at the curves👇 Presented by Dr. @bensolomon1 👏👏 @OncoAlert https://t.co/YlqcMBkS9i https://t.co/E4kgtnUDi8
11,101 views 60 likes 26 RT 2024-05-31
Benjamin Besse
Benjamin Besse @BenjaminBesseMD
Lorlatinib PFS is impressive with an HR 0.19 over crizotinib. But why after 5 yrs FU can’t we see the OS curves and the cross over rate? Even if the number of events is not reached, that would help us to select our first line treatment. @ALKPositiveinc #ASCO24 https://t.co/j0NfRyvB0r
9,506 views 121 likes 36 RT 2024-06-01
Aakash Desai, MD, MPH
Aakash Desai, MD, MPH @ADesaiMD
➡️ CROWN Study: Lorlatinib vs Crizotinib in ALK+ NSCLC - 5-Year Follow-Up 📊 Results: - PFS: Lorlatinib 🏆 60% (5-yr) vs Crizotinib 8% - IC Progression: Lorlatinib NR vs Crizotinib 16.4 mo 🧠 - Grade 3/4 AEs: 77% Lorlatinib vs 57% Crizotinib ⚠️ - Treatment Discontinuation: 5%… https://t.co/NJxJW4fu12 https://t.co/PkIRSjFEPf
7,537 views 29 likes 8 RT 2024-05-31
Eric K. Singhi, MD
Eric K. Singhi, MD @lungoncdoc
In case you missed it: real progress is happening in ALK+ NSCLC. And we are just getting started. Here’s to what’s next. @myESMO #ELCC26 https://t.co/2KvQF6nhOw https://t.co/NMsRO2WjMR
6,984 views 70 likes 26 RT 2026-03-25
H. Jack West, MD, FASCO
H. Jack West, MD, FASCO @JackWestMD
IMO, results are truly remarkable, even in world where we expect strong efficacy from targeted Rx in enriched pop'n. Ironically, going for easy win v criz was aiming too low & hurt lorlatinib. If shown to soundly beat alectinib H2H, IMO it'd be broadly adopted w/fewer Qs now. https://t.co/7e5eBkftKV
6,178 views 39 likes 7 RT 2024-06-02
Charu Aggarwal, MD, MPH, FASCO
Charu Aggarwal, MD, MPH, FASCO @CharuAggarwalMD
#ASCO24 @ASCO Lung Orals today will be 🔥 #CROWN data shows unprecendented PFS, NR at 5 year follow up. Incredible results. Looking forward to @bensolomon1's presentation! @ALKPositiveinc @n8pennell @GlopesMd @NarjustFlorezMD @StephenVLiu @DrSteveMartin @ADesaiMD @OncoAlert… https://t.co/2a4oYGjqxQ https://t.co/v7PrnterhL
5,467 views 49 likes 16 RT 2024-05-31

CROWN Overview

CROWN (NCT03052608) is the pivotal Phase 3 trial that established lorlatinib (Lorbrena) as a first-line standard of care for advanced ALK-positive NSCLC. Lorlatinib is a third-generation CNS-penetrant ALK TKI engineered to overcome resistance mutations including the broad spectrum of secondary kinase-domain alterations that emerge on earlier-generation TKIs. At ASCO 2026 (Abstract 8502, published in Annals of Oncology), investigators presented the 7-year update — the longest randomized follow-up reported for a 1L NSCLC targeted therapy — with median PFS still not reached in the lorlatinib arm and a striking sustained CNS-protection signal, reinforcing lorlatinib as the practice-defining frontline option for ALK+ NSCLC.

Population

Treatment-naïve, advanced ALK-positive NSCLC (n=296), with or without baseline CNS metastases.

Intervention

Lorlatinib 100 mg orally once daily vs crizotinib 250 mg twice daily.

Primary Endpoint

Progression-free survival by blinded independent central review (RECIST 1.1).

Key Secondary

Overall survival (key secondary), investigator-assessed PFS, objective response (ORR), intracranial ORR, intracranial time to progression, duration of response (DOR), intracranial DOR, safety, and biomarker analyses.

Reported Results

Progression-Free Survival (Primary — 7-Year Update)

At a median follow-up of 83.0 months for lorlatinib (vs 77.2 mo crizotinib) at the data cutoff (Oct 31, 2025), the median PFS remains NOT REACHED with lorlatinib vs 9.1 months (95% CI, 7.4–10.9) with crizotinib — HR 0.19 (95% CI, 0.13–0.27). The 7-year PFS rate is 55% with lorlatinib vs 3% with crizotinib (5-yr rates were 60% vs 8% per Solomon JCO 2024). Among patients event-free at 24 months on lorlatinib, the conditional probability of being progression-free at year 7 is 79%. 44% of lorlatinib patients remain on first-line treatment at the cutoff — the longest sustained PFS ever reported in advanced NSCLC.

Lorlatinib vs crizotinib · 7-yr PFS 55% vs 3% · HR 0.19Source: ASCO 2026 Abstract 8502 (Mok) · Solomon JCO 2024

Intracranial Disease Control

Zero new intracranial progression events have occurred after 30 months on lorlatinib. Median time to intracranial progression is NOT REACHED with lorlatinib vs 16.4 months (95% CI, 12.7–21.9) with crizotinib — HR 0.06 (95% CI, 0.03–0.12). From prior 5-yr data: 5-year intracranial PFS rate was 92% with lorlatinib in patients without baseline brain metastases. KOLs (Akhade, Shah, Halmos) have called this the most striking CNS-protection signal of any targeted therapy in solid tumors.

Lorlatinib vs crizotinib · Median time to IC progression NR vs 16.4 mo · HR 0.06Source: ASCO 2026 Abstract 8502 (Mok) · Solomon JCO 2024

Safety & Tolerability (7-Year)

Long-term lorlatinib tolerability is stable: treatment-related AE-driven discontinuation was only 5% on lorlatinib vs 6% on crizotinib, with no new permanent treatment-related discontinuations after 26 months. Dose reductions (34% on lorlatinib) did not compromise long-term efficacy. Class-defining lorlatinib AEs persist (hypercholesterolemia 72%, hypertriglyceridemia 66%, peripheral edema 57%, increased weight 44%, peripheral neuropathy 44%, cognitive effects 28%); these are actively managed with statin therapy, dose modification, and counseling.

TRAE-disc · Lorlatinib 5% vs crizotinib 6%Source: ASCO 2026 Abstract 8502 (Mok) · Solomon JCO 2024

FDA & Approval Status

STATUSFDA-approved 1L for ALK+ NSCLC since March 2021

Lorlatinib (Lorbrena) received FDA approval for the first-line treatment of advanced ALK-positive NSCLC in March 2021, based on the primary CROWN analysis. The subsequent 5-year (Solomon JCO 2024) and 7-year (ASCO 2026 Abstract 8502) updates reinforce its position as the standard-of-care 1L ALK TKI in major guidelines (NCCN, ESMO, ASCO).

Source: FDA — lorlatinib 1L approval (March 2021)

Media Coverage

What KOLs Are Saying

KOLCommentSentiment
Normand Blais, MD 🌻
#ASCO24 · May 31, 2024
No matter what @VPrasadMDMPH may say, these results are outstanding and never seen before in lung cancer, ever! Positive
Paolo Tarantino
#ASCO24 · May 31, 2024
Truck test ✅ #CROWN #lcsm https://t.co/IHvSnJS6Z5 https://t.co/hS6f7pYRpJ Positive
Marcelo Corassa, MD.
#ASCO24 · May 31, 2024
So, 5y PFS is out. CROWN shows that only 3% of patients had disease progression from year 4 to year 5. Toxic, Lorlatinib is indeed, but this in totally unprecedented in thoracic oncology. ALK fusion patients leading the way into making NSCL Positive
gilberto lopes
#ASCO26 · May 22, 2026
Remarkable is an understatement! #ASCO26 7-yr update (Abstract 8502, CROWN): 1L lorlatinib in advanced ALK+ NSCLC — median PFS STILL not reached at 7 years, the longest ever in advanced NSCLC. 7-yr PFS 55% vs 3% for crizotinib. Clear 24 m Positive
Charu Aggarwal, MD, MPH, FASCO
#ASCO24 · May 31, 2024
Let’s take a minute. Have we seen anything like this in NSCLC before? mPFS NR at 5 years? 👏🏽👏🏽👏🏽👏🏽 These curves are very impressive, and should urge us to think about management of AEs and optimize 1L Tx for ALK+ NSCLC @ASCO #ASCO24 @ALKP Positive
Laura Alder, MD
#ASCO26 · May 21, 2026
🧵 CROWN 7-Year Update: Lorlatinib in 1L ALK+ NSCLC: the longest PFS ever reported in advanced NSCLC keeps getting longer!!! #ASCO26 🫁 Abstracts! Presenter: @TonyMok9 Key takeaways: 👇 @ALKPositiveinc 1) 1/ 📈 Median PFS STILL not reached Positive
Nathan A. Pennell MD, PhD, FASCO
#ASCO24 · May 31, 2024
Not to steal the thunder from the oral session today, but this is the CROWN PFS curve, more or less flat between 2-5 years and still 60% progression free at 5 years! #ASCO24 #LCSM Is it worth the side effects of lorlatinib to turn ALK+ NSC Neutral
Vinay Prasad MD MPH
#ASCO24 · May 31, 2024
Its great to see #asco24 changing language. In the future, I would love to see @asco make sure All randomized studies use appropriate control arms (sorry CROWN) All RCTs provide appropriate post protocol care (sorry ADAURA) These choices s Negative
Charu Aggarwal, MD, MPH, FASCO
#ASCO24 · May 31, 2024
The curve again! 👑 #ASCO24 @ASCO https://t.co/PlDA2tfpvQ https://t.co/kgQ1ry4eeN Neutral
Yakup Ergün
#ASCO24 · May 31, 2024
#ASCO24 CROWN study: lorlatinib vs crizotinib Lorlatinib..... no need to comment, look at the curves👇 Presented by Dr. @bensolomon1 👏👏 @OncoAlert https://t.co/YlqcMBkS9i https://t.co/E4kgtnUDi8 Positive
Benjamin Besse
#ASCO24 · Jun 1, 2024
Lorlatinib PFS is impressive with an HR 0.19 over crizotinib. But why after 5 yrs FU can’t we see the OS curves and the cross over rate? Even if the number of events is not reached, that would help us to select our first line treatment. @AL Mixed
Aakash Desai, MD, MPH
#ASCO24 · May 31, 2024
➡️ CROWN Study: Lorlatinib vs Crizotinib in ALK+ NSCLC - 5-Year Follow-Up 📊 Results: - PFS: Lorlatinib 🏆 60% (5-yr) vs Crizotinib 8% - IC Progression: Lorlatinib NR vs Crizotinib 16.4 mo 🧠 - Grade 3/4 AEs: 77% Lorlatinib vs 57% Crizotinib Neutral
Eric K. Singhi, MD
#ELCC26 · Mar 25, 2026
In case you missed it: real progress is happening in ALK+ NSCLC. And we are just getting started. Here’s to what’s next. @myESMO #ELCC26 https://t.co/2KvQF6nhOw https://t.co/NMsRO2WjMR Neutral
H. Jack West, MD, FASCO
#ASCO24 · Jun 2, 2024
IMO, results are truly remarkable, even in world where we expect strong efficacy from targeted Rx in enriched pop'n. Ironically, going for easy win v criz was aiming too low & hurt lorlatinib. If shown to soundly beat alectinib H2H, IMO it Positive
Charu Aggarwal, MD, MPH, FASCO
#ASCO24 · May 31, 2024
#ASCO24 @ASCO Lung Orals today will be 🔥 #CROWN data shows unprecendented PFS, NR at 5 year follow up. Incredible results. Looking forward to @bensolomon1's presentation! @ALKPositiveinc @n8pennell @GlopesMd @NarjustFlorezMD @StephenVLiu Positive
Sanjay Popat
#ASCO24 · May 31, 2024
.@bensolomon1 presents 5yr post hoc CROWN. mPFS with lorli still not reached! HR=0.19, 60% 5yr PFS rate for Lori. Durable PFS median NR if CNS+/- at baseline. Durable neuro protective effect. No efficacy change by dose reduction. No ALK-M+ Positive
Aɴᴛᴏɴɪᴏ Pᴀssᴀʀᴏ
#ASCO24 · May 31, 2024
The long-term benefits of Lorlatinib are indeed IMPRESSIVE🎺, but it's still important to consider potential toxicities and side effects when evaluating its overall safety profile. Are you sure that we need to define Lorlatinib as toxic? #AS Mixed
The Innovation Oncology
#ASCO24 · May 31, 2024
Lorlatinib Versus Crizotinib in Patients With Advanced ALK-Positive Non–Small Cell Lung Cancer: 5-Year Outcomes From the Phase III CROWN Study @ASCO @JCO_ASCO @JCOOP_ASCO #MedEd #MedX #Oncology #ASCO2024 #ASCO24 https://t.co/vvSDvi3rd6 ht Neutral
Hidehito HORINOUCHI
#ASCO26 · May 22, 2026
🆙 #ASCO26 #LCSM Oral 🔥CROWN: Lorlatinib vs Crizotinib in ALK+ NSCLC ✅mPFS NR (HR 0.19) ✅7-yr PFS 55% vs 3% ✅44% still on lorlatinib at 7y ✅No new IC progression after 30m 🎙️ @TonyMok9 🔢8502 ☑️NCT03052608 🔗 https://t.co/GgYuAT7iil @OncoAler Positive
Vinay Prasad MD MPH
#ASCO24 · May 31, 2024
How the hell did Crown run with an inferior control arm? Alectinib beat Crizo in 2017. @Timothee_MD https://t.co/I1SkFKB9A9 #ASCO24 Negative
Hidehito HORINOUCHI
posted Apr 26, 2026
🆙 #ASCO26 #LCSM Oral Abstract Session 🔥CROWN: Lorlatinib vs Crizotinib as First-Line Treatment for Advanced ALK+ NSCLC: 7-Year Update 🎙️ @TonyMok9 🔢8502 ☑️NCT03052608 🔗 https://t.co/GgYuAT6KsN @OncoAlert @Larvol @ASCO https://t.co/CVByWraV Positive
d.planchard
#ASCO24 · May 31, 2024
Superb presentation @bensolomon1 and results that will convince us to begin 1st-line treatment with lorlatinib in our ALK patients...@ASCO #ASCO24 https://t.co/5rpD9lUYYH Positive
Chul Kim
#ASCO24 · May 31, 2024
Great discussion by @JessicaJLinMD on CROWN, PALOMA-3, MARIPOSA! A must-watch. #ASCO24 https://t.co/lLmq0JcYNV Positive
Hidehito HORINOUCHI
#ASCO26 · May 27, 2026
🆙 @OncoAlert #ASCO26 #LCSM 🔝🔟Abstracts Leads: @HHorinouchi @UOzkerim @WeOncologists 1 HARMONi-6 2 LIBRETTO-432 3 WU-KONG28 4 OptiTROP-Lung05 5 TRITON 6 CROWN 7yr 7 LORIN 8 AcceleRET-Lung 9 Silevertinib 10 Concurrent CRT + durvalumab in ES-S Neutral
Christine Lovly, MD, PhD
#ASCO24 · May 31, 2024
Dr. @benlevylungdoc has a fun + educational game “Name the KM curve”. ⬇️ These KM curves for CROWN 👑 = unprecedented! Truly impressive. Research = Progress #ASCO24 @OncoAlert @ALKPositiveinc https://t.co/nubupWqT28 Positive