Second-Line Lurbinectedin Shows Activity, Acceptable Safety in SCLC

In a phase 2 study of patients with small-cell lung cancer (SCLC), second-line lurbinectedin was active and yielded a manageable safety profile (Lancet Oncol. 2020;21[5]:645-654).

“Few options exist for treatment of patients with [SCLC] after failure of first-line therapy. Lurbinectedin is a selective inhibitor of oncogenic transcription,” explained José Trigo, MD, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Spain, and colleagues, who assessed the safety and activity of lurbinectedin in patients with SCLC that did not respond to platinum-based chemotherapy.

A total of 105 adults with SCLC and no brain metastasis who had received 1 chemotherapy-containing line of treatment at least 3 weeks before study initiation were enrolled in the single-arm, open-label trial between October 16, 2015, and January 15, 2019.

These patients were recruited from 26 hospitals across Europe and the United States, and given lurbinectedin 3.2 mg/m² administered as a 1-hour intravenous infusion every 3 weeks until disease progression or unacceptable toxicity occurred.

The primary end point was the percentage of patients with an overall response, and follow-up lasted for a median of 17.1 months.

Ultimately, the investigators observed responses in 37 (35.2%) patients (95% CI, 26.2-45.2). Regardless of causality, the most common grade 3-4 adverse events were hematologic abnormalities, including anemia (9%), leucopenia (29%), neutropenia (46%), and thrombocytopenia (7%).

There were no treatment-related deaths documented.

“Lurbinectedin was active as second-line therapy for SCLC in terms of overall response and had an acceptable and manageable safety profile,” Dr Trigo and co-investigators said.

“Lurbinectedin could represent a potential new treatment for patients with SCLC, who have few options especially in the event of a relapse, and is being investigated in combination with doxorubicin as second-line therapy in a randomised phase 3 trial,” they concluded.—Hina M. Porcelli