Relapsed small-cell lung cancer: a disease of continued unmet need
Mené sur 613 patients atteints d'un cancer du poumon à petites cellules récidivant (durée médiane de suivi : 24,1 mois), cet essai multicentrique de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité d'un traitement combinant lurbinectédine et doxorubicine par rapport à une chimiothérapie de deuxième ligne choisie par le médecin (topétécan ou chimiothérapie de type CAV)
Despite immunotherapeutic advancements in the treatment of front-line extensive-stagesmall-cell lung cancer (SCLC), the majority of patients will have disease progressionwithin 6 months. Such a reality places increased importance on identifying effective and tolerablesystemic therapy options in this key relapsed setting. Lurbinectedin, a selectiveoncogenic transcription inhibitor, was approved by the US Food and Drug Administrationfor patients with extensive-stage SCLC with disease progression on or after platinum-basedchemotherapy on the basis of results from a single-arm phase 2 basket trial. In thisstudy, 35·2% of patients had an overall response, with a median progression-free survivalof 4·6 months and overall survival of 9·3 months. Haematological abnormalities were the most common treatment-associated toxicity,with grade 3 or worse neutropenia occurring in 46% of patients. With these encouragingresults, lurbinectedin quickly ascended as a potential therapeutic alternative totopotecan in the relapsed setting, despite absence of randomised phase 3 data confirmingsuperiority in survival outcomes.
The Lancet Respiratory Medicine , commentaire, 2021