Lorlatinib

drug
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Also known as LorbrenaLorviquaPF-06463922NALORLATINIB_

Summary

Lorlatinib (CHEMBL3286830) is an approved small-molecule antineoplastic agent (ATC L01ED05) targeting ALK, ROS1, and FES; indicated across 10 conditions including non-small cell lung carcinoma and neoplasm; with CIViC clinical evidence for 25 variant-indication associations (e.g. ALK Fusion in lung non-small cell carcinoma).

At a glance

  • Status: Approved (max clinical phase 4)
  • Modality: Small molecule
  • ATC class: L01ED05
  • Targets: 3 (ALK, ROS1, FES)
  • Indications: 10 conditions
  • Clinical trials: 60
  • Precision-oncology evidence (CIViC): 25 variant–indication associations
  • Chemistry: 406.4 Da · C21H19FN6O2

Identifiers

Drug identity and classification

FieldValue
ChEMBL IDCHEMBL3286830
NameLorlatinib
TypeSmall molecule
Max phase4
FDA approvedyes
PubChem CID71731823
ChEBICHEBI:143117
ATCL01ED05
Molecular formulaC21H19FN6O2
Molecular weight406.4
InChIKeyIIXWYSCJSQVBQM-LLVKDONJSA-N

SMILES: C[C@@H]1C2=C(C=CC(=C2)F)C(=O)N(CC3=NN(C(=C3C4=CC(=C(N=C4)N)O1)C#N)C)C

IUPAC name: (16R)-19-amino-13-fluoro-4,8,16-trimethyl-9-oxo-17-oxa-4,5,8,20-tetrazatetracyclo[16.3.1.02,6.010,15]docosa-1(22),2,5,10(15),11,13,18,20-octaene-3-carbonitrile

ChEBI definition: A cyclic ether that is 16,17-dihydro-2H-8,4-(metheno)pyrazolo[4,3-h][2,5,11]benzoxadiazacyclotetradecin-15(10H)-one substituted by methyl groups at positions 2 and 10R, and by cyano, amino and fluoro groups at positions 3, 7 and 12 respectively. It is a small molecule inhibitor of ALK and ROS1 kinase developed by Pfizer for the treatment of ALK-positive non-small cell lung cancer.

Pharmacological roles (ChEBI): antineoplastic agent, EC 2.7.10.1 (receptor protein-tyrosine kinase) inhibitor.

Also known as: Lorbrena, Lorlatinib, Lorviqua, PF-06463922, LORLATINIB, NA, LORLATINIB_, lorlatinib

Parent form; salt/anhydrous children: CHEMBL4539157, CHEMBL6068047

Patent coverage: 1,575 distinct patent families (3,598 SureChEMBL compound mentions), from 3 matched compound structure(s). One matched structure accounts for 3,106 (86%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

GeneTargetActionpAffinityCancer dependencyUniProt
ALKALK receptor tyrosine kinaseInhibition9.150.8%Q9UM73
ROS1c-ros oncogene 1, receptor tyrosine kinaseInhibition11.30.1%P08922
FESFES proto-oncogene, tyrosine kinaseInhibition8.220.2%P07332

Broader ChEMBL bioactivity targets: 24 (assay-derived). Sample: 5-hydroxytryptamine receptor 2B, Epidermal growth factor receptor, 5-hydroxytryptamine receptor 1A, Acetylcholinesterase, Adenosine receptor A3, Focal adhesion kinase 1, High affinity nerve growth factor receptor, 3’,5’-cyclic-AMP phosphodiesterase 4D, Tyrosine-protein kinase JAK2, Nuclear receptor subfamily 1 group I member 2.

Bioactivity

ChEMBL activities: 83 potent at pChembl ≥ 5 of 85 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

TargetpChemblTypeValueUnitActivity ID
ROS110Ki0.1nMCHEMBL_ACT_18761145
ROS110Ki0.1nMCHEMBL_ACT_22395851
SLC34A29.72IC500.19nMCHEMBL_ACT_22424896
ALK9.7IC500.2nMCHEMBL_ACT_14722505
EML49.7IC500.2nMCHEMBL_ACT_18761148
CD749.64IC500.23nMCHEMBL_ACT_22424892
CD749.52IC500.3nMCHEMBL_ACT_29238079
SLC34A29.4IC500.4nMCHEMBL_ACT_29238047
ALK9.15Ki0.7nMCHEMBL_ACT_14722369
ALK9.15Ki0.7nMCHEMBL_ACT_18285545
ALK9.15Ki0.7nMCHEMBL_ACT_18761156
ALK9.15Ki0.7nMCHEMBL_ACT_22424890
ALK9.15Ki0.7nMCHEMBL_ACT_25683778
ALK8.89IC501.3nMCHEMBL_ACT_14722560
EML48.89IC501.3nMCHEMBL_ACT_18761147
ALK8.89IC501.3nMCHEMBL_ACT_24953979
ALK8.8IC501.6nMCHEMBL_ACT_14722507
EML48.8IC501.6nMCHEMBL_ACT_18761149
LTK8.57IC502.7nMCHEMBL_ACT_14722558
LTK8.57Ki2.7nMCHEMBL_ACT_24958176
FER8.48IC503.3nMCHEMBL_ACT_14722519
FER8.48Ki3.3nMCHEMBL_ACT_24958172
ALK8.38IC504.2nMCHEMBL_ACT_14722511
EML48.38IC504.2nMCHEMBL_ACT_18761151
ALK8.26IC505.5nMCHEMBL_ACT_28859399
ALK8.26IC505.5nMCHEMBL_ACT_28859453
ALK8.26IC505.5nMCHEMBL_ACT_28859459
ALK8.26IC505.5nMCHEMBL_ACT_28859465
ALK8.26IC505.5nMCHEMBL_ACT_28859471
ALK8.26IC505.5nMCHEMBL_ACT_28859477

Target pathways

Aggregated over 3 target gene(s): ALK, ROS1, FES.

Top Reactome pathways

21 total, by targets touching each:

PathwayTargetsGenes
Signaling by SCF-KIT1FES
Signal Transduction1ALK
Disease1ALK
Signaling by ALK1ALK
Sema3A PAK dependent Axon repulsion1FES
SEMA3A-Plexin repulsion signaling by inhibiting Integrin adhesion1FES
CRMPs in Sema3A signaling1FES
Diseases of signal transduction by growth factor receptors and second messengers1ALK
Signaling by Receptor Tyrosine Kinases1ALK
Signaling by ALK in cancer1ALK
ALK mutants bind TKIs1ALK
Drug resistance of ALK mutants1ALK
ASP-3026-resistant ALK mutants1ALK
NVP-TAE684-resistant ALK mutants1ALK
alectinib-resistant ALK mutants1ALK
brigatinib-resistant ALK mutants1ALK
ceritinib-resistant ALK mutants1ALK
crizotinib-resistant ALK mutants1ALK
lorlatinib-resistant ALK mutants1ALK
Signaling by ALK fusions and activated point mutants1ALK
MDK and PTN in ALK signaling1ALK

Dominant GO biological processes

GO termTargets
protein phosphorylation3
signal transduction2
cell surface receptor protein tyrosine kinase signaling pathway2
regulation of cell population proliferation2
protein autophosphorylation2
response to stress1
phosphorylation1
hippocampus development1
adult behavior1
swimming behavior1
peptidyl-tyrosine autophosphorylation1
regulation of apoptotic process1
regulation of neuron differentiation1
neuron development1
negative regulation of lipid catabolic process1

Indications & clinical

Indications

10 indications (4 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

IndicationTrial phaseMONDOEFO
non-small cell lung carcinoma4MONDO:0005233EFO:0003060
neoplasm4MONDO:0005070EFO:0000616
lymphoma4MONDO:0005062EFO:0000574
neuroblastoma3MONDO:0005072EFO:0000621
ganglioneuroblastoma3MONDO:0005035EFO:0000502
anaplastic large cell lymphoma2MONDO:0020325EFO:0003032
lung neoplasm2MONDO:0021117MONDO:0008903
kidney disorder1MONDO:0005240EFO:0003086
liver disorder1MONDO:0005154EFO:0001421

1 further indication record had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 60.

Phase distribution

PhaseTrials
PHASE218
Not specified18
PHASE111
PHASE45
PHASE1/PHASE24
PHASE33
EARLY_PHASE11

Top trials by phase / activity

NCTPhaseStatusTitle
NCT05144997PHASE4ACTIVE_NOT_RECRUITINGLorlatinib Continuation Study
NCT06282874PHASE4ACTIVE_NOT_RECRUITINGLorlatinib in Patients With ALK-Positive NSCLC With Brain or Leptomeningeal Metastases
NCT06893354PHASE4NOT_YET_RECRUITINGExplore the Mechanisms Underlying Disease Resistance and Potential Primary Resistance Mechanism of Induction Therapy Lorlatinib in Resectable Non-small Cell Lung Cancer (NSCLC) Harboring ALK Positive Mutation Revealed by Single-cell RNA Sequencing and Spatial Transcriptomics
NCT04362072PHASE4COMPLETEDStudy of Lorlatinib In People With ALK-positive Non-small Cell Lung Cancer
NCT04541706PHASE4COMPLETEDLorlatinib in ALK Inhibitor Treated Unresectable Advanced/Recurrent ALK-Positive Non Small Cell Lung Cancer Patients in India
NCT03052608PHASE3ACTIVE_NOT_RECRUITINGA Study Of Lorlatinib Versus Crizotinib In First Line Treatment Of Patients With ALK-Positive NSCLC
NCT03126916PHASE3RECRUITINGTesting the Addition of 131I-MIBG or Lorlatinib to Intensive Therapy in People With High-Risk Neuroblastoma (NBL)
NCT06858410PHASE3NOT_YET_RECRUITINGLorlatinib Compared with Concurrent/ Sequential Chemoradiotherapy in Stage III ALK Positive Lung Adenocarcinoma
NCT02925234PHASE2RECRUITINGThe Drug Rediscovery Protocol (DRUP Trial)
NCT04127110PHASE2ACTIVE_NOT_RECRUITINGActivity of Lorlatinib Based on ALK Resistance Mutations Detected on Blood in ALK Positive NSCLC Patients
NCT04621188PHASE2ACTIVE_NOT_RECRUITINGLorlatinib After Failure of First-line TKI in Patients With Advanced ROS1-positive NSCLC (ALBATROS)
NCT05297890PHASE2ACTIVE_NOT_RECRUITINGA Study of Lorlatinib in Subjects With ROS1-Positive Non-Small Cell Lung Cancer
NCT05740943PHASE2ACTIVE_NOT_RECRUITINGInduction Lorlatinib in Stage III Non-small Cell Lung Cancer
NCT06007937PHASE1/PHASE2RECRUITINGA Study of Lorlatinib in Combination With Ramucirumab in People With Lung Cancer
NCT06378892PHASE2RECRUITINGA Study to Evaluate the Combination of Platinum-pemetrexed Based Chemotherapy Plus Lorlatinib in ALK Positive Non-Small Cell Lung Cancer (NSCLC) With Exclusively Extracranial Disease Progression on Lorlatinib
NCT06682884PHASE2NOT_YET_RECRUITINGLorlatinib as Neoadjuvant Treatment in Stage IB-IIIB ALK-rearranged Non-Small Cell Lung Cancer
NCT07083687PHASE2NOT_YET_RECRUITINGLorlatinib in ROS1+ NSCLC With Brain Metastasis
NCT07415005PHASE2RECRUITINGLorlatinib Plus Local Consolidation Therapy In ALK Positive Advanced Non-Small Cell Lung Cancer
NCT01970865PHASE1/PHASE2COMPLETEDA Study Of PF-06463922 An ALK/ROS1 Inhibitor In Patients With Advanced Non Small Cell Lung Cancer With Specific Molecular Alterations
NCT02584634PHASE1/PHASE2TERMINATEDStudy to Evaluate Safety, Efficacy, Pharmacokinetics And Pharmacodynamics Of Avelumab In Combination With Either Crizotinib Or PF-06463922 In Patients With NSCLC. (Javelin Lung 101)
NCT02927340PHASE2UNKNOWNA Study of Lorlatinib in Advanced ALK and ROS1 Rearranged Lung Cancer With CNS Metastasis in the Absence of Measurable Extracranial Lesions
NCT03439215PHASE2UNKNOWNPF-06463922 for Crizotinib Pretreated ROS1 Positive Non-small-cell Lung Cancer
NCT03505554PHASE2UNKNOWNA Study of Oral Lorlatinib in Patients With Relapsed ALK Positive Lymphoma
NCT03612154PHASE2UNKNOWNStudy of Lorlatinib in ROS1 Rearranged NSCLC
NCT03737994PHASE2TERMINATEDTargeted Treatment for ALK Positive Patients Who Have Previously Been Treated for Non-squamous Non-small Cell Lung Cancer
NCT03909971PHASE2COMPLETEDA Study of Lorlatinib in ALK Inhibitor-Treated ALK-Positive NSCLC in China
NCT04111705PHASE2COMPLETEDLorlatinib After Failure of First-line Second-generation ALK Kinase Inhibitor in Patients With Advanced ALK-positive Non-small Cell Lung Cancer
NCT04292119PHASE1/PHASE2UNKNOWNLorlatinib Combinations in Lung Cancer
NCT05097599PHASE2TERMINATEDStrataPATH™ (Precision Indications for Approved Therapies)
NCT05948462PHASE2WITHDRAWNLorlatinib in Combination With Chemotherapy in Participants With Metastatic Anaplastic Lymphoma Kinase Positive (ALK+) Non-small Cell Lung Cancer (NSCLC) Who Progressed on Single-agent Lorlatinib
NCT02564562PHASE1COMPLETEDA Study To Investigate The Absorption, Distribution, Metabolism, And Excretion Of [14c]PF-06463922 In Healthy Male Volunteers
NCT02569554PHASE1COMPLETEDPPI And Food Effect Study For PF-06463922 In Healthy Volunteers
NCT02804399PHASE1COMPLETEDA Study To Evaluate The Effect Of Rifampin On Pharmacokinetics Of PF-06463922 In Healthy Volunteers
NCT02838264PHASE1COMPLETEDA Study To Evaluate The Effect Of Itraconazole On Pharmacokinetics Of PF-06463922 In Healthy Volunteers
NCT03107988PHASE1COMPLETEDNANT 2015-02: A Phase 1 Study of Lorlatinib (PF-06463922)
NCT03542305PHASE1COMPLETEDLorlatinib Renal Impairment Study
NCT03726333PHASE1TERMINATEDHepatic Impairment Study for Lorlatinib in Cancer Patients
NCT03878524PHASE1TERMINATEDSerial Measurements of Molecular and Architectural Responses to Therapy (SMMART) PRIME Trial
NCT03961997PHASE1COMPLETEDEffect of Multiple Doses of Modafinil on the Pharmacokinetics of Single Dose Lorlatinib in Healthy Participants
NCT04800822PHASE1TERMINATEDPF-07284892 in Participants With Advanced Solid Tumors

Clinical evidence (CIViC)

Variant × indication × effect (25 predictive associations from 28 curated evidence items):

VariantIndicationEffectTherapyLevelCIViC
ALK FusionLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC AEID11191 +3
ALK MutationLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC AEID11286
ROS1 FusionLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC BEID11335
ALK FusionInflammatory Myofibroblastic TumorSensitivity/ResponseLorlatinibCIViC CEID11294
EML4::ALK Fusion AND ALK C1156YLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC CEID842
EML4::ALK Fusion AND ALK I1171N AND ALK L1196MMalignant Pleural MesotheliomaSensitivity/ResponseLorlatinibCIViC CEID11113
FN1::ALK FusionInflammatory Myofibroblastic TumorSensitivity/ResponseLorlatinibCIViC CEID11292
ROS1 S1986Y/FLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC CEID7689
TPM4::ALK FusionInflammatory Myofibroblastic TumorSensitivity/ResponseLorlatinibCIViC CEID11293
EML4::ALK Fusion AND ALK G1202R AND ALK I1171N AND ALK L1196MMalignant Pleural MesotheliomaResistanceLorlatinibCIViC CEID11114
EML4::ALK Fusion AND ALK G1202R AND ALK L1196MLung Non-small Cell CarcinomaResistanceLorlatinibCIViC CEID7591
EML4::ALK Fusion AND ALK L1198F AND ALK C1156YLung Non-small Cell CarcinomaResistanceLorlatinibCIViC CEID843
ALK F1174LNeuroblastomaSensitivity/ResponseLorlatinibCIViC DEID1329
ALK F1245CNeuroblastomaSensitivity/ResponseLorlatinibCIViC DEID1330
ALK R1275QNeuroblastomaSensitivity/ResponseLorlatinibCIViC DEID1331
EML4::ALK FusionLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC DEID1332
EML4::ALK Fusion AND ALK G1202RCancerSensitivity/ResponseLorlatinibCIViC DEID7593
EML4::ALK Fusion AND ALK L1196MCancerSensitivity/ResponseBrigatinib + Lorlatinib + Alectinib + CeritinibCIViC DEID7597
GOPC::ROS1 e7::e35GlioblastomaSensitivity/ResponseLorlatinibCIViC DEID7483
ROS1 G2032R AND v::ROS1 FusionLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC DEID1251
ROS1 L2026M AND CD74::ROS1 FusionLung Non-small Cell CarcinomaSensitivity/ResponseLorlatinibCIViC DEID1253
EML4::ALK Fusion AND ABCB1 OverexpressionLung AdenocarcinomaResistanceLorlatinib + AlectinibCIViC DEID10016
EML4::ALK Fusion AND ALK C1156YCancerResistanceLorlatinib + Alectinib + Ceritinib + BrigatinibCIViC DEID7609
EML4::ALK Fusion AND ALK G1202R AND ALK L1196MCancerResistanceBrigatinib + Crizotinib + Lorlatinib + Alectinib + CeritinibCIViC DEID7592
EML4::ALK Fusion AND ALK G1202R AND ALK L1198FCancerResistanceAlectinib + Lorlatinib + Brigatinib + CeritinibCIViC DEID7595

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline or drug-level clinical/variant annotations in PharmGKB for this molecule.

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

99 molecules share ≥1 primary target. Top 60 by shared-target count:

MoleculeSourceStatusShared targets
ALECTINIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
CRIZOTINIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
ENTRECTINIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
ERLOTINIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
FEDRATINIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
GILTERITINIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
PAZOPANIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
RUXOLITINIBChEMBL + PubChemPhase 4 (approved)ALK, FES, ROS1
BRIGATINIBChEMBLPhase 4 (approved)ALK, FES, ROS1
CERITINIBChEMBLPhase 4 (approved)ALK, FES, ROS1
NINTEDANIBChEMBLPhase 4 (approved)ALK, FES, ROS1
LESTAURTINIBChEMBLPhase 3ALK, FES, ROS1
BMS-754807ChEMBLPhase 2ALK, FES, ROS1
FORETINIBChEMBLPhase 2ALK, FES, ROS1
R-406ChEMBLPhase 2ALK, FES, ROS1
TOZASERTIBChEMBLPhase 2ALK, FES, ROS1
AfatinibPubChemApprovedALK, FES, ROS1
GefitinibPubChemApprovedALK, FES, ROS1
IdelalisibPubChemApprovedALK, FES, ROS1
SelumetinibPubChemApprovedALK, FES, ROS1
BOSUTINIBChEMBL + PubChemPhase 4 (approved)ALK, FES
PALBOCICLIBChEMBL + PubChemPhase 4 (approved)ALK, FES
REPOTRECTINIBChEMBL + PubChemPhase 4 (approved)ALK, ROS1
SUNITINIBChEMBL + PubChemPhase 4 (approved)ALK, FES
VANDETANIBChEMBL + PubChemPhase 4 (approved)ALK, FES
INFIGRATINIBChEMBLPhase 4 (approved)ALK, ROS1
MIDOSTAURINChEMBLPhase 4 (approved)ALK, ROS1
LINIFANIBChEMBLPhase 3ALK, FES
ROCILETINIBChEMBLPhase 3ALK, FES
BI-2536ChEMBLPhase 2ALK, FES
CENISERTIBChEMBLPhase 2ALK, ROS1
ILORASERTIBChEMBLPhase 2ALK, ROS1
OSI-632ChEMBLPhase 2ALK, ROS1
PELITINIBChEMBLPhase 2ALK, FES
REBASTINIBChEMBLPhase 2FES, ROS1
SELITRECTINIBChEMBLPhase 2ALK, ROS1
belumosudilPubChemApprovedALK, ROS1
LapatinibPubChemApprovedFES, ROS1
MomelotinibPubChemApprovedFES, ROS1
QuizartinibPubChemApprovedFES, ROS1
SorafenibPubChemApprovedFES, ROS1
AXITINIBChEMBLPhase 4 (approved)ROS1
DASATINIBChEMBLPhase 4 (approved)FES
LAROTRECTINIBChEMBLPhase 4 (approved)ROS1
MITOXANTRONEChEMBLPhase 4 (approved)ROS1
NERATINIBChEMBLPhase 4 (approved)FES
OSIMERTINIBChEMBLPhase 4 (approved)ALK
UPADACITINIBChEMBLPhase 4 (approved)ALK
ALISERTIBChEMBLPhase 3ROS1
ALVOCIDIBChEMBLPhase 3ALK
CANERTINIBChEMBLPhase 3ALK
CEDIRANIBChEMBLPhase 3ALK
DACTOLISIBChEMBLPhase 3ALK
DOVITINIBChEMBLPhase 3ALK
ENTOSPLETINIBChEMBLPhase 3ROS1
QUERCETINChEMBLPhase 3ALK
RUBOXISTAURINChEMBLPhase 3ROS1
SEMAXANIBChEMBLPhase 3ALK
BEMCENTINIBChEMBLPhase 2ALK
CEP-11981ChEMBLPhase 2ALK