Real-World Outcomes With Lurbinectedin in Second-Line Setting and Beyond for Extensive Stage Small Cell Lung Cancer.

Background: Lurbinectedin has emerged as a potential treatment option for relapsed small cell lung cancer (SCLC). While clinical trials have demonstrated its efficacy and safety, real-world data are limited. This study aimed to evaluate the safety and efficacy of lurbinectedin in a real-world setting, focusing on its use as a second-line agent and beyond in SCLC patients.
Methods: A retrospective analysis was conducted on 90 patients who received lurbinectedin between June 2020 and June 2022 within the Mayo Clinic Health System. Of these, 50 patients received lurbinectedin as a second-line agent, and 14 patients received it as a third-line or later agent. The primary outcomes assessed were overall survival (OS), progression-free survival (PFS), and treatment-related adverse events.
Results: Lurbinectedin was generally well tolerated in this real-world cohort, with a median OS of 5.1 months in the second-line cohort and 5.6 months in the third-line or later cohort. Median PFS was 2.1 months in the second-line cohort and 3.4 months in the third-line or later cohort. Adverse events were manageable, with the most common being neutropenia, anemia, fatigue, and febrile neutropenia. No treatment-related deaths or grade 5 toxicities were reported.
Conclusion: This real-world study provides valuable insights into the safety and efficacy of lurbinectedin in relapsed SCLC. Lurbinectedin demonstrated modest efficacy and a comparable safety profile to that observed in clinical trials. However, outcomes for relapsed SCLC remain suboptimal, particularly for patients with a shorter chemotherapy-free interval and central nervous system metastases.
Competing Interests: Disclosure A.D: Advisory board: Amgen, Sanofi. C.S, Y.A, J.O, S.Z, A.P, C.H, N.M, A.S, J.M, Y.Z, P.S, K.P: Reports no relevant conflicts of interest. R.M: Consulting/advisory board for: AstraZeneca, Turning points, Janssen, Takeda, Y.L: Advisory board: AstraZeneca Pharmaceuticals, Janssen Pharmaceutical, Lilly Oncology, Turning point therapeutics, Consultant: AstraZeneca, Honorarium: clarion health care, Research Funding Support: Merck, MacroGenics, Tolero Pharmaceuticals, AstraZeneca, Vaccinex, Blueprint Medicines, Harpoon Therapeutics, Sun Pharma Advanced Research, Bristol-Myers Squibb, Kyowa Pharmaceuticals, Tesaro, Bayer HealthCare, Mirati Therapeutics, Daiichi Sankyo, V.E: Consulting/advisory board for: AstraZeneca, Daiichi Sanyo, Jazz Pharmaceuticals, Bayer, Pfizer, and Novocure, A.D: Advisory board: TP Therapeutics, Guardant Health, Chromacode, Anheart Therapeutics., A.S.M: is supported by a Mark Foundation ASPIRE Award, NCI R21 CA251923, and Department of Defense W81XWH-22-1-0021 Concept Award. Advisory Boards: AbbVie, AstraZeneca, BeiGene, BMS, Genentech, Inc., Janssen; Travel support and honoraria from Shanghai Roche Pharmaceuticals Ltd., and is non-remunerated member of the Mesothelioma Applied Research Foundation and Friends of Patan Hospital Board of Directors. K.L: consulting activities with Boehringer Ingelheim Pharmaceuticals, Amgen, AstraZeneca, Targeted Oncology, Takeda, Jazz Pharmaceuticals, Mirati Therapeutics, Janssen, and Regeneron; CME activities with OncLive and MJH Life Sciences; Research support (to institution) from AstraZeneca and Mirati Therapeutics.Clinical trial support: Novartis, Syntrix Therapeutics, Sorrento Therapeutics, Anheart Therapeutics, Merck; Honoraria: Roche/Genentech, Intellisphere.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)