This is a summary of a research study (known as a clinical trial) called CROWN. The study tested two medicines called
lorlatinib and
crizotinib in participants with untreated
non-small cell lung cancer that had spread to other parts of their body. All those who took part had changes in a gene called ALK, which is involved in cell growth. In total, 296 participants from 23 countries took part. Half the participants took
lorlatinib and half took
crizotinib. After participants started taking
lorlatinib or
crizotinib, they were checked regularly to see if their tumors had grown or spread to other parts of their body (known as
tumor progression) and to monitor any side effects. After 1 year of treatment, the participants who took
lorlatinib were twice as likely to be alive with no
tumor growth as the participants who took
crizotinib. More participants who took
lorlatinib had
cancer that shrank (76%) compared with the participants who took
crizotinib (58%). This was also true of the participants whose
cancer had spread to their brain. The most common side effects in participants who took
lorlatinib were increases in the amount of
cholesterol and
triglycerides (a type of fat) in their blood, swelling,
weight gain, nerve damage, unclear thoughts, and
diarrhea. Among the participants who took
crizotinib, the most common side effects were
diarrhea, feeling like you want to throw up, sight problems, swelling,
vomiting, changes in liver function, and feeling tired. Overall, the CROWN study showed that fewer participants with advanced ALK+
non-small cell lung cancer died or had
tumor growth with
lorlatinib compared with
crizotinib treatment. ClinicalTrials.gov NCT number: NCT03052608.