Second-Line Sacituzumab Govitecan Shows Promise for Extensive-Stage Small Cell Lung Cancer

According to results from the phase 2 TROPiCS-03 study, sacituzumab govitecan demonstrated promise as a second-line option for patients with extensive-stage small cell lung cancer (ES-SCLC). 

“Second-line treatment options for ES-SCLC are limited and have important efficacy and safety considerations,” stated Afshin Dowlati, MD, Seidman Cancer Center, Cleveland, Ohio, and coauthors. “In a phase 1/2 IMMU-132-01 basket study, [sacituzumab govitecan] had encouraging antitumor activity in patients with heavily pretreated SCLC, despite many trial patients having been previously exposed to standard-of-care topotecan.” 

In this multi cohort, open-label study, 43 patients with either platinum-resistant (n = 20) or platinum-sensitive (n = 23) ES-SCLC who experienced disease progression after prior platinum-based chemotherapy and anti-PD-L1–based therapy were assigned to receive 10 mg/kg of sacituzumab govitecan on days 1 and 8 of a 21-day cycle. The primary end point was investigator-assessed objective response rate (ORR). Key secondary end points included investigator-assessed ORR based on platinum sensitivity, duration of response, progression-free survival (PFS), and safety. 

At analysis, the investigator-assessed ORR was 41.9% with 18 confirmed partial responses. The ORR was 35% among patients with platinum-resistant disease and 47.8% among patients with platinum-sensitive disease. The median duration of response was 4.73 months, the median PFS was 4.4 months, and the median OS was 13.6 months. Grade ≥3 treatment-emergent adverse events occurred in 74.4% of patients. No treatment-emergent adverse events led to treatment discontinuation. One treatment-related death was reported due to neutropenic sepsis. 

“[Sacituzumab govitecan] has promising efficacy as second-line treatment of ES-SCLC, irrespective of platinum sensitivity,” concluded Dr Dowlati et al. “A phase 3 trial of [sacituzumab govitecan] in patients with previously treated ES-SCLC is warranted.”

Source:

Dowlati A, Chiang AC, Cervantes A, et al. Phase 2 open-label study of sacituzumab govitecan as second-line therapy in patients with extensive-stage SCLC: Results from TROPiCS-03. J Thorac Oncol. Published online: January 1, 2025. doi:  10.1016/j.jtho.2024.12.028