CHICAGO — The LURBICLIN study has analyzed the real-world data of French patients with small-cell lung cancer (SCLC) who received lurbinectedin to assess the efficacy of this new second-line treatment. The results show that lurbinectedin is a wholly acceptable treatment option with seemingly greater efficacy than standard treatments, according to a poster that Nicolas Girard, MD, respiratory medicine specialist and coordinator of the Curie-Montsouris Chest Center in Paris, presented at the ASCO 2023 annual meeting.
SCLC is a condition with limited treatment options, and the decision about whether to administer a second-line treatment in the event of relapse is complex. No treatment route is specifically recommended, although several options are possible.
Lurbinectedin, a new medicinal product that was developed from a sea creature (see box), is one such option. It proved effective in relapsing small-cell cancer in a phase 2 study. These results led to fast-track approval by the FDA in 2020 and early-access use in France in the same year for adult patients with SCLC whose disease had worsened after platinum-based chemotherapy.
Led by Girard, alongside the French-language lung cancer group (the IFCT), the LURBICLIN study enrolled 312 patients overall. About 64% of participants were men, median age was 65 years, 72% of the population were PS0-1, 47% had brain metastases, and 58% had a previous history of immunotherapy.
Lurbinectedin was administered as second-line treatment in 44% of patients. Approximately 58% of participants were refractory to chemotherapy. Patients received a median of three cycles of lurbinectedin. Concurrent radiotherapy on metastases was delivered to 38% of patients.
The response rate was 22%, and the disease control rate was 38%. After a median follow-up of 20.8 months, median progression-free survival (PFS) and overall survival (OS) were 1.9 and 4.7 months, respectively. Six-month PFS and OS rates were 7% and 42%, respectively.
Performance status (PS) ≤ 2 and chemotherapy-free interval ≥ 90 days were associated with significantly longer OS (hazard ratio 0.71 and 0.58, respectively).
“By analyzing the real-world data of 312 patients in France who have received this medicinal product, we’re showing that lurbinectedin is a new treatment option for patients with small-cell lung cancer,” commented Girard.
Lurbinectedin (Zepzelca), also known as PM1183, is an analog of the marine compound ET-736 isolated from the sea squirt Ecteinascidia turbinata in which a hydrogen atom has been replaced by a methoxy group. It is a selective inhibitor of the oncogenic transcription programs on which many tumors particularly depend. Together with its effect on cancer cells, lurbinectedin inhibits oncogenic transcription in tumor-associated macrophages, downregulating the production of cytokines that are essential for the growth of the tumor.
This article was translated from the Medscape French Edition.
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