Neurocognitive Adverse Events Related to Lorlatinib in Non-Small Cell Lung Cancer: A Systematic Review and

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Jonathan N Priantti1, Maysa Vilbert2, Francisco Cezar Aquino de Moraes3

  • 1School of Medicine, Federal University of Amazonas-UFAM, Manaus 69020-160, AM, Brazil.

Cancers
|July 27, 2024
PubMed

Insights

Lorlatinib treats ALK/ROS1-positive non-small cell lung cancer but can cause neurocognitive adverse events (NAEs). Early detection and management of these NAEs are crucial for improving patient quality of life.

Area of Science:

  • Oncology
  • Pharmacovigilance
  • Neuroscience

Background:

  • Lorlatinib is an FDA-approved therapy for ALK/ROS1-positive non-small cell lung cancer (NSCLC).
  • Neurocognitive adverse events (NAEs) are a known concern with lorlatinib treatment.
  • Effective management of NAEs is essential for maintaining patient quality of life.

Purpose of the Study:

  • To systematically review and meta-analyze the frequency of NAEs associated with lorlatinib in NSCLC patients.
  • To identify specific types of NAEs, including cognitive, mood, speech, and psychotic effects.
  • To compare NAE frequencies reported in clinical trials versus real-world data.

Main Methods:

  • A systematic literature search was conducted across PubMed, Scopus, Cochrane Library, and conference proceedings.
  • Included studies focused on lorlatinib treatment in NSCLC patients, with a total of 1147 patients from 12 studies.
  • Pooled analysis was performed to determine the frequencies of various NAEs.

Main Results:

  • Pooled analysis revealed NAE frequencies: cognitive effects (14.57%), mood effects (11.17%), speech effects (7.24%), and psychotic effects (4.97%).
  • A significant proportion of patients (62%) had brain metastases, a factor potentially influencing NAEs.
  • Clinical trials indicated a higher frequency of mood effects compared to real-world data.

Conclusions:

  • Lorlatinib therapy is associated with a notable incidence of NAEs in NSCLC patients.
  • Healthcare professionals and patients require education on lorlatinib-related NAEs for timely recognition and intervention.
  • Proactive management of NAEs is vital for enhancing the quality of life for NSCLC patients undergoing lorlatinib treatment.
Keywords:
ALKROS1adverse effectslorlatiniblung cancer

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