Lorbrena (lorlatinib)

Reviewed by: HU Medical Review Board | Last reviewed: September 2023

Lorbrena® (lorlatinib) is a treatment for people with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC). Metastatic lung cancers are lung cancers that have spread from the initial lung location to other parts of the body.1

How does lorlatinib work?

In people with ALK-positive lung cancer, there is a mutation in the gene that produces the protein ALK. This mutation causes cancer cells to grow and multiply more quickly. Lorlatinib blocks the ALK protein, which may slow or stop the growth of lung cancer cells.1

Lorlatinib can be the first drug prescribed for those with ALK-positive metastatic NSCLC. It can also be a second, third, or later treatment. While there are other ALK inhibitors, many peoples’ lung cancer becomes resistant to them. Resistant lung cancers may worsen until an alternative therapy is prescribed. Lorlatinib can be an alternative for people whose cancer is resistant to certain other ALK inhibitors.2,3

What are the possible side effects?

The most common side effects of lorlatinib include:1,4

  • Swelling (edema)
  • Tingling or pain in the hands or feet (peripheral neuropathy)
  • Cognitive effects
  • Trouble breathing
  • Fatigue
  • Weight gain
  • Joint pain
  • Mood effects
  • Diarrhea
  • Cough
  • High levels of cholesterol and/or triglycerides

Some people may also experience more serious side effects. Serious side effects of lorlatinib may include:1,4

  • Risk of serious liver problems (caused by potential drug interactions)
  • Seizures
  • Hallucinations
  • Other nervous system problems
  • Increases in cholesterol or lipids (triglycerides)
  • Slow or abnormal heart rhythm
  • Lung problems such as difficulty breathing, shortness of breath, or cough
  • Increased blood sugar
  • High blood pressure

These are not all the possible side effects of lorlatinib. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with lorlatinib.

Other things to know

Before starting treatment with lorlatinib, talk to your doctor about all your medical conditions, including if you:1,4

  • Have a history of depression or seizures
  • Have high levels of cholesterol or triglycerides
  • Have a history of heartbeat problems
  • Have lung or breathing problems
  • Have high blood pressure, diabetes, or issues with your kidneys
  • Are pregnant or planning to become pregnant
  • Are breastfeeding or plan to breastfeed

Lorlatinib can harm an unborn baby. Women who can become pregnant and men with partners who can become pregnant should use birth control during treatment and for some time after the last dose of lorlatinib. Women should also not breastfeed during treatment with lorlatinib and for some time after the last dose. Talk to your doctor about your options for birth control and breastfeeding while taking lorlatinib.1,4

Lorlatinib may reduce fertility in men, which could affect their ability to father a child.1,4

Before beginning treatment for lung cancer, tell your doctor about all your health conditions and any other medicines, vitamins, or supplements you are taking. This includes over-the-counter drugs.

Patients should talk to their doctor if they have any questions regarding their lorlatinib regimen, or any questions at all. Patients should take their medication as prescribed by their doctor.

For more information, read the full prescribing information for lorlatinib.

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