In a nutshell
This study evaluated the safety and effectiveness of an experimental treatment, lurbinectedin, in patients with small-cell lung cancer (SCLC) after unsuccessful treatment with platinum-based chemotherapy. The authors found that this treatment showed promising effectiveness and manageable side effects in these patients.
SCLC accounts for about 15% of all lung cancers. This tumor type is particularly aggressive, with rapid growth and early spread (metastasis). When the spread is limited, it is treated with radiotherapy and platinum-based chemotherapy. However, some patients do not respond to this first line regimen. Topotecan (Hycamtin), another anticancer drug has been used as a second-line treatment in these patients. However, it is highly toxic and only 16% of patients show a positive response.
Lurbinectedin is an experimental treatment that interferes with cancer genes and leads to cancer cell death. It has shown promising results in combination with doxorubicin (Adriamycin) for patients with unresponsive SCLC in a small study. However, the safety and effectiveness of lurbinectedin alone as a second-line treatment in SCLC remains under investigation.
Methods & findings
105 adults with SCLC were recruited. All patients had previously received and failed one line of platinum-based chemotherapy. They were given lurbinectedin once every three weeks. Patients received an average of 4 cycles. Response to treatment was assessed with CT scans or MRIs. Patients were followed-up for an average of 17.1 months.
65% of patients had reductions in tumors. The overall response rate was 35.2%. The average survival without cancer worsening was 3.5 months, overall. The average overall survival was 9.3 months. In patients who responded to treatment, the average overall survival was 12.6 months.
There were no treatment-related deaths. The most common side effects were neutropenia (low white blood cells which help fight off infections; 46%), anemia (low red blood cells; 9%), and low platelet (blood cells involved in clotting; 7%) levels. 10% of patients had serious side effects. These included neutropenia with and without fever and pneumonia (lung infection).
The bottom line
This study showed that lurbinectedin has promising effectiveness and manageable side effects as a second-line treatment for SCLC.
The fine print
This study was small and had a short follow-up period. Also, there was no control group in which lurbinectedin was compared to another treatment. This study was funded by Pharma Mar, the manufacturer of lurbinectedin.
Lurbinectedin has not been approved by the FDA yet, as more, larger studies are required to verify its safety and effectiveness.
Published By :
The Lancet. Oncology
Mar 27, 2020