Cancer Medicines Outcomes Programme Public Health Scotland (CMOP-PHS) report
Lorlatinib monotherapy for anaplastic lymphoma kinase (ALK) positive advanced non-small cell lung cancer patients previously treated with an ALK inhibitor

About this release

This release by Public Health Scotland (PHS) uses information from the National SACT dataset.

This work was requested by the Scottish Medicines Consortium (SMC) to support their decision-making processes. Lorlatinib was accepted for use within NHSScotland on an interim basis subject to ongoing evaluation and future reassessment by the SMC on 9th March 2020.

The aim of this pilot work was to capture real-world evidence from Scotland on the use of lorlatinib monotherapy for treatment of anaplastic lymphoma kinase (ALK) positive advanced non-small cell lung cancer (NSCLC) patients previously treated with an ALK inhibitor.

The objectives were to:

• Describe the baseline characteristics of patients receiving lorlatinib monotherapy for advanced NSCLC previously treated with an ALK inhibitor
• Describe treatment characteristics including mean and median duration of treatment
• Provide information on treatment pathways including prior and subsequent systemic anti-cancer therapy (SACT)
• Estimate overall survival (OS) from the start of lorlatinib treatment.

Main points

• This report provides descriptive information on the 32 patients prescribed lorlatinib monotherapy following previous treatment with an anaplastic lymphoma kinase (ALK) inhibitor for presumed ALK positive advanced non-small cell lung cancer (NSCLC) from 1st January 2020 to 30th April 2024 in clinical practice.
• The median treatment duration was 8.3 months (Interquartile Range (IQR) 2.5 - 15.1).
• At time of censor date 21 (66%) patients had died with a median overall survival (OS) of 14.4 months (95% confidence intervals (CI) 8.4 - not available).

Background

Cancer Medicines Outcome Programme (CMOP) Background

The overall vision of the Cancer Medicines Outcomes Programme - Public Health Scotland (CMOP-PHS) collaboration is to better understand the real-life impact of cancer medicines on cancer patients in Scotland. Healthcare professionals may then use these findings to help support clinical decision making and enable a more bespoke and individualised approach to the provision of cancer care for all our patients. Developing, and refining, a robust and reliable process means that cancer medicines intelligence may be routinely generated to support informed decision making at individual, local, and national levels.

Together with information available from clinical trials, this additional knowledge is intended to help NHS Scotland deliver a more personalised approach to providing cancer care, and to help ensure the safe and effective use of medicines.

The CMOP-PHS collaboration builds on established clinical engagement across NHS Scotland Health Boards and integrates with key stakeholders, thereby bringing together clinical, academic and data analysis skills from the NHS, Public Health Scotland, and academia, alongside the patient and public voice. The collaboration provides organisational memory and supports workforce resilience, embedding robust processes to routinely generate and report real-world evidence (RWE). This supports the provision of patient-centred cancer care and decision-making processes, setting Scotland apart as a centre of excellence in the cancer medicines RWE arena

Scottish Medicines Consortium

The Scottish Medicines Consortium (SMC) considers a broad range of evidence to decide which medicines should be accepted for use nationally by NHSScotland. The committee is made up of clinicians, pharmacists, NHS board representatives, the pharmaceutical industry and the public. More information can be found here.

SMC accepted, on an interim basis, lorlatinib monotherapy following ALK inhibitor for treatment of anaplastic ALK positive advanced NSCLC 9th March 2020.