Pfizer’s ALK lung cancer drug Lorviqua lands 1st-line reimbursement in Korea

Pfizer Korea has secured reimbursement for Lorviqua (lorlatinib) as a first-line treatment for ALK-positive metastatic non-small cell lung cancer (NSCLC), a move that could expand access for younger, non-smoking patients facing high risk of brain metastasis.

The greenlight took effect Thursday and came three years after Korea approved the third-generation ALK inhibitor for use in newly diagnosed patients. Until now, the lack of reimbursement meant many couldn’t afford the therapy despite its proven edge over older drugs like crizotinib.

Lorviqua targets a gene fusion known as ALK, found in a small subset of NSCLC patients, who make up more than 80 percent of all lung cancer cases. ALK-positive disease tends to strike younger patients with little to no smoking history and is notorious for spreading to the brain..

Nearly one in four are already facing brain metastases at diagnosis, with almost half developing them within two years.

“Given the clinical profile of ALK-positive lung cancer, starting strong from day one is crucial,” Professor Kim Sang-we of the Department of Oncology at Asan Medical Center said in a statement. “The reimbursement of Lorviqua as a first-line treatment is a welcome development for patients who’ve faced cost barriers.”

In the global phase 3 CROWN trial, Pfizer’s Lorviqua reduced the risk of disease progression or death by 81 percent versus crizotinib (HR = 0.19; 95% CI: 0.13–0.27). Median progression-free survival (PFS) wasn’t reached in the Lorviqua arm after 60.2 months of follow-up, compared to 9.1 months for crizotinib. Five-year PFS rates came in at 60 percent versus 8 percent, respectively.

Among Asian patients, outcomes were consistent: Lorviqua posted a 78 percent reduction in progression risk (HR = 0.22), with median PFS still not reached and five-year PFS hitting 63 percent versus 7 percent for crizotinib.