Lorlatinib is administered continuously without a fixed course of treatment and needs to be dynamically adjusted based on disease progression and tolerance. As an ALK/ROS1 inhibitor, its treatment cycle is evaluated with disease control as the core indicator.

1. Standard dosing regimen

(1) Basic usage: Take 100mg orally once a day, continue treatment until disease progression or unacceptable toxicity occurs.

(2) Course characteristics: Different from the traditional chemotherapy cycle, the efficacy needs to be evaluated through imaging every 6-8 weeks, and the decision to continue or adjust the treatment is made based on the results.

2. Duration of clinical treatment

(1) Median treatment period: Clinical trial data shows that the median duration of medication is about 18.3 months, and some sensitive patients may exceed 3 years.

(2) Individual differences: The actual duration of medication is influenced by multiple factors such as tumor molecular typing, baseline load, and ability to manage adverse reactions.

3 key factors affecting the number of treatment courses

(1) Drug resistance mechanism: Approximately 60% of patients experience treatment interruption due to acquired resistance, commonly occurring between 12-36 months of medication.

(2) Toxicity management: 15% of patients terminate treatment due to grade 3 or above adverse reactions, and side effects need to be controlled through dose adjustments.

4. Handling of special circumstances

(1) Dose adjustment: When central neurotoxicity or hyperlipidemia occurs, it may be necessary to reduce the dosage to 75mg/50mg for daily maintenance treatment.

(2) Combination therapy: Combination therapy with CYP3A4 potent inducers can shorten the effective treatment time and should be avoided.