Can lorlatinib treat osimertinib-resistant lung cancer? Does it apply to EGFR mutations?

Lorlatinib (lorlatinib) is a third-generation ALK/ROS1 inhibitor initially used primarily for ALK-positive non-small cell lung cancer (NSCLC). In recent years, with the deepening of research, lorlatinib (lorlatinib) has also been discussed as a treatment for EGFR mutant lung cancer after resistance to osimertinib. For some patients, finding new treatments becomes particularly critical when osimertinib, a third-generation EGFR inhibitor, fails.

Whether lorlatinib can treat osimertinib-resistant lung cancer depends on the patient's resistance mechanism. Studies have found that some osimertinib-resistant patients may have new driver gene mutations outside of the EGFR gene, such as rare EGFR complex Mutation (such as C797S), MET amplification or ALK fusion, etc. In these special circumstances, if a patient acquires a resistance mechanism such as an ALK fusion, lorlatinib may be a promising option. Therefore, in actual clinical practice, whether to use lorlatinib (lorlatinib) needs to be based on the results of genetic testing after resistance.

However, lorlatinib is not a targeted drug specifically designed to target EGFR mutations. For patients with simple EGFR mutations (such as L858R or 19 exon deletion), even if they are resistant to osimertinib, they generally will not directly choose lorlatinib (lorlatinib) as a subsequent treatment drug. A more common approach is to select MET inhibitors, anti-EGFR antibodies, chemotherapy or combination immunotherapy based on the resistance mechanism. Therefore, for most patients with EGFR mutations that are resistant to osimertinib, lorlatinib (lorlatinib) is not the first choice.

In general, lorlatinib (lorlatinib) can be used in the treatment of lung cancer after resistance to osimertinib in a few specific cases, but whether it is suitable depends on detailed molecular testing reports. After patients develop resistance to osimertinib, they should undergo genetic re-testing in a timely manner to clarify the resistance mechanism and choose the most appropriate treatment plan under the guidance of a doctor. Do not blindly change medications to avoid delaying the best treatment opportunity.

Reference link:https://www.lorbrena.com/