Lorbrena

Lorbrena is the brand name for lorlatinib, a targeted cancer therapy in the class of tyrosine kinase inhibitors. Lorlatinib is a third-generation inhibitor of anaplastic lymphoma kinase (ALK) and also inhibits ROS1 to a lesser extent. It is designed to penetrate the blood-brain barrier and is active against many ALK resistance mutations, including those that can arise after prior ALK inhibitor therapy. This CNS activity makes it a treatment option for patients with brain metastases.

In the United States, Lorbrena is indicated for adults with ALK-positive metastatic non-small cell lung cancer whose disease has progressed on or is intolerant to one or more ALK inhibitors. It has demonstrated activity against intracranial disease and is commonly used in patients who have CNS involvement or who have progressed after other ALK-targeted therapies. The drug is also being studied in other ALK-driven settings, though its approved use remains primarily NSCLC.

Lorbrena is taken orally, usually at a dose of 100 mg once daily, with or without food. Because lorlatinib is metabolized by CYP3A enzymes, concomitant strong CYP3A inhibitors or inducers may require dose adjustments or avoidance. Dose modifications and monitoring may be needed for drug interactions or significant toxicities.

Common adverse effects include hyperlipidemia (elevated cholesterol and triglycerides), edema, weight gain, cognitive and mood changes, peripheral neuropathy, and liver enzyme elevations. Patients typically require regular monitoring of lipid levels, liver function, and neurological status. Lorbrena was developed by Pfizer and received FDA approval for ALK-positive NSCLC after prior ALK inhibitor therapy in 2018.