Lorlatinib as the First-line Treatment in China Advanced ALK+ NSCLC

This is a patient-centric, two cohorts, open-label, multi-center, phase II study in China, designed to prospectively enroll 126 advanced ALK+NSCLC patients, including 84 subjects fulfilled CROWN criteria as "CROWN criteria (CC) cohort", and another 42 subjects beyond CROWN criteria as "compassionate use (CU) cohort". Subjects will receive continuous daily PO dosing of lorlatinib 100mg QD, from the date of first dosing until disease progression, unacceptable toxicity, or withdrawal for any reason, or death, whichever occurs first. The primary endpoints are progression-free survival (PFS) of CC cohort per investigator, and resistance mechanism of first-line lorlatinib. Secondary endpoints are 1/2/3-year PFS, cumulative rate of central nervous system (CNS) progression, intracranial-time to progression (IC-TTP), objective response rate (ORR) and intracranial ORR (IC-ORR), overall survival (OS), safety and PRO. Exploratory endpoints include evaluation of candidate biomarkers of sensitivity or resistance to lorlatinib, dynamic ctDNA change during treatment, and effective treatment after lorlatinib resistance.