Lurbinectedin shows potential for second-line SCLC treatment
medwireNews: Lurbinectedin monotherapy is active in the second-line treatment of both platinum-sensitive and -resistant small-cell lung cancer (SCLC), according to phase II results presented at the 2019 ASCO Annual Meeting.
Speaking at the meeting in Chicago, Illinois, USA, Luis Paz-Ares (Hospital Universitario 12 de Octubre, Madrid, Spain) reported an objective response rate (ORR) of 35.2% with second-line lurbinectedin (3.2 mg/m2 intravenously every 3 weeks) in a cohort of 105 SCLC patients, with a disease control rate of 68.6% and median duration of response of 5.3 months.
This activity translated into improved survival, with median progression-free survival (PFS) of 3.9 months and median overall survival (OS) of 9.3 months, and a 6-month PFS rate of 33.6% and 12-month OS rate of 34.2%.
SCLC is an aggressive malignancy with a high unmet medical need, said the presenter. Topotecan is the only treatment to have been licensed for the second-line treatment of SCLC by the US FDA in the last 20 years, and is approved only for platinum-sensitive disease.
Therefore, it is of note that lurbinectedin showed antitumor activity against not only platinum-sensitive disease (defined by a chemotherapy-free interval ≥90 days, n=60) but also platinum-resistant (chemotherapy-free interval <90 days, n=45) disease, with ORRs of 45.0% and 22.2%, respectively, and median durations of response of 6.2 and 4.7 months.
Median PFS was 4.6 months for individuals with platinum-sensitive disease and 2.6 months for those with platinum-resistant tumors, with corresponding 6-month rates of 44.6% and 18.8%. Similarly, median OS was 11.9 months in the platinum-sensitive group and 5.0 months in the platinum-resistant group, while the 12-month OS rates were 48.3% and 15.9%, respectively.
The safety profile of lurbinectedin was described as “favorable and manageable” by the presenter; the most common grade 3 or 4 adverse event was neutropenia, which occurred in 22.9% of patients, while grade 1 or 2 fatigue was seen in 51.4% of patients and nausea in 32.4%. There were no adverse event-related deaths and only 1.9% of events led to treatment discontinuation.
“Lurbinectedin emerges as a potential new treatment alternative for [second-line] SCLC,” Paz-Ares concluded.
By Catherine Booth
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