Pfizer's Lorbrena makes play for earlier lung cancer use with Xalkori-topping data

If Pfizer wants targeted lung cancer med Lorbrena to be a true follow-up to Xalkori, it has to get the product cleared in previously untreated ALK-positive patients. And it just took a step toward achieving that goal.

In a phase 3 trial, Lorbrena showed it could outdo predecessor Xalkori at keeping lung cancer progression at bay. The company is keeping detailed results under wraps for now, but it’ll be sharing them with global regulators in hopes of moving the therapy earlier into treatment.

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Right now, Lorbrena—a third-generation ALK inhibitor—bears an accelerated green light only in patients who have already tried one or more other options. In order to give the drug a try, patients first need to receive Roche’s Alecensa; Novartis’ Zykadia; or Pfizer’s own Xalkori, plus another ALK inhibitor in the second-line setting.

Those stipulations illustrate just how crowded the front-line market currently is, thanks to the newer Roche and Novartis drugs that joined Xalkori there in 2017. Alecensa topped Pfizer’s elder med at staving off cancer progression on the way to its FDA approval, and at this year’s virtual ASCO meeting, the Roche therapy showed it could best Xalkori at lengthening patients’ lives, too.

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Despite the hefty competition, a move into the first-line space would still be a win for Lorbrena, whose sales have been limited since its FDA go-ahead in late 2018. Pfizer didn’t break out Q1 sales of the drug, instead lumping it in with its other low-selling oncology products, a group that together generated $192 million. Xalkori, meanwhile, churned out $149 million, while Alecensa, the class sales leader, rung up CHF 268 million ($295.9 million) on the back of 43% growth.