CROWN
The trial with the longest disease control ever seen for a targeted lung cancer pill: most patients still progression-free at five years.
296 patients. At 5 years, PFS was 60% with lorlatinib versus 8% with crizotinib (HR 0.19); median PFS not reached after >60 months of follow-up. Intracranial progression was nearly abolished (5-year cumulative incidence ~8% in patients without baseline brain metastases). Neurocognitive, mood, weight, and lipid effects require management.
- 60 vs 8 out of 100 alive without the cancer growing at 5 years with Lorlatinib compared with Crizotinib; 52 more per 100.
- Roughly one extra person helped for every 2 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Put another way, the treated group had about 81 percent lower chance of the event at any given time (hazard ratio 0.19, likely range 0.13 to 0.27).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- 8 vs 40 out of 100 reached this endpoint at 5 years with Lorlatinib compared with Crizotinib; 32 fewer per 100.
- On this measure the first group did worse, not better.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: First-line ALK-positive advanced NSCLC: lorlatinib vs crizotinib. People in a different situation may not see the same effect.
- The trial selected people by a biomarker (ALK); the result should not be assumed for people whose cancer does not have it.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
296 participants enrolled.
Cumulative incidence in patients without baseline brain metastases
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 5 years (BICR)primary | Lorlatinib | 149 | 60% | 0.19 (0.13–0.27) | — | link |
| Crizotinib | 147 | 8% | ||||
| Intracranial progression at 5 years | Lorlatinib | — | 8% | — | — | link |
| Crizotinib | — | 40% |
Pages like this
not linked directly; found by shared links- PersonJustin F. Gainor
Shares Lorlatinib, ALK, Non-small-cell lung cancer.
- Key paperCROWN: lorlatinib versus crizotinib as first treatment for ALK-positive lung cancer
Shares Benjamin Solomon, Lorlatinib, ALK, Non-small-cell lung cancer.
- PersonDong-Wan Kim
Shares Lorlatinib, ALK, Non-small-cell lung cancer.
- ProductEnsartinib
Shares ALK, Non-small-cell lung cancer.
- ProductNeladalkib
Shares Lorlatinib, ALK, Non-small-cell lung cancer.
- ProductCeritinib
Shares ALK, Non-small-cell lung cancer.
- TrialALKOVE-1
Shares ALK, Non-small-cell lung cancer.
- ProductBrigatinib
Shares ALK, Non-small-cell lung cancer.