Evidence map›Paper›PMID 41291327›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

Lorlatinib and neurocognitive adverse events: characterization, risk factors, and the potentially mitigative role of social support.

Ryan Brown, Katie E Smith, Mohamed M Shanshal, Anastasios Dimou, Konstantinos Leventakos, Kaushal Parikh, Aaron S Mansfield, Julian R Molina, Matthew P Goetz, Aminah Jatoi and 1 more

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ryan BrownDepartment of Medicine, Cleveland Clinic, Cleveland, OH, USA.
Katie E SmithDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Mohamed M ShanshalDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Anastasios DimouDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Konstantinos LeventakosDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Kaushal ParikhDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Aaron S MansfieldDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Julian R MolinaDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Matthew P GoetzDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Aminah JatoiDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. jatoi.aminah@mayo.edu.ORCID http://orcid.org/0000-0002-1081-189X
Elizabeth Cathcart-RakeDepartment of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.

Funding

Screening Mammography: Early Breast Cancer Detection for All at RiskK23MD019644 · NIMHD · MAYO CLINIC ROCHESTER · PI Elizabeth Cathcart-Rake · 2024 to 2026
$467k
NIMHD NIH HHS K23 MD019644NIMHD NIH HHS K23MD019644
6 · The paper itself

Abstract

purposeLorlatinib is the preferred first-line treatment for patients with ALK+ metastatic non-small cell lung cancer. However, this drug carries high rates of neurocognitive adverse events. This study further characterized these neurocognitive adverse events, examined risk factors, and, for the first time, explored social support as a mitigation strategy.

methodsThe Mayo Clinic medical record was interrogated for patients prescribed lorlatinib between July 2017 and May 2022, and medical records were reviewed in detail.

resultsSixty-three patients were prescribed lorlatinib (median age: 59 years (range: 37-82); 31 (49%) men). Twenty-five (40%) developed a neurocognitive adverse event, which had been characterized as follows: "hallucinations," "noise confusion," "obtunded," "memory loss," "trouble doing simple tasks," "mental fogginess," "vivid dreams," and "nightmares." In univariable analyses, age, gender, prior brain metastases, concomitant CYP3A inducers or inhibitors, and married/partner status were not statistically significantly predictive of the neurocognitive adverse event. In multivariable analyses, older age (≥ 65 years) was predictive (HR: 2.6 (95% CI: 1.09, 6.26); p = 0.03). Notably, 3 of 14 married/partnered patients (21%) and 5 of 6 non-married/partnered patients (83%) were hospitalized for a neurocognitive adverse event (p = 0.02, Fisher's Exact test). Medical record content corroborated the importance of married/partnered ("spouse is very supportive") and of non-married/partnered status ("patient lives alone" and "children some distance away").

conclusionsThis study further characterized lorlatinib-associated neurocognitive adverse events and confirmed older age as a risk factor. Importantly, social support may prevent hospitalization for a neurocognitive adverse event, and, thus, merits further study, perhaps in older patients.

Indexed as

Antineoplastic AgentsCarcinoma, Non-Small-Cell LungLactamsLactams, MacrocyclicLung NeoplasmsNeurocognitive DisordersSocial SupportAdultAgedAged, 80 and overAminopyridinesFemaleHumansMaleMiddle AgedPyrazolesAminopyridinesAntineoplastic AgentsLactamsLactams, MacrocycliclorlatinibPyrazolesAgeHospitalizationLorlatinibNeurocognitive adverse eventsSocial support

Identifiers

PMID41291327

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.