Outcome and safety of lurbinectedin as compassionate use in extensive stage small cell lung cancer: a multicentric international cohort
Menée à partir de données portant sur 238 patients atteints d'un cancer du poumon à petites cellules de stade étendu, cette étude de cohorte internationale évalue l'efficacité, du point de vue du taux de réponse objective, du taux de contrôle de la maladie, de la survie sans progression et de la survie globale, et la toxicité de la lurbinectédine dans un usage compassionnel
Introduction: Lurbinectedin has recently emerged in the treatment landscape of extensive stage (ES) small cell lung cancer (SCLC). Here we report the outcomes and safety of lurbinectedin within a named patient program in a multicentric, international cohort.
Methods: Clinical data of all patients with ES-SCLC treated with lurbinectedin at the Erasmus Medical Center (EMC, Rotterdam-The Netherlands) and the Veneto Institute of Oncology (IOV, Padua-Italy) were collected.
Results: A total of 238 patients receiving lurbinectedin as second- (37%), third- (45%) or further-line (18%) were included. Median number of cycles was 3 (1-22). The objective response rate was 23.1%, the disease control rate 45.5%. The median progression free survival (PFS) 2.2 months (95%CI 1.6-2.8) and the median overall survival (OS) 5.4 months (95%CI 4.5-6.3). Patients with a chemotherapy-free interval (CFI) ≥ 90 days showed a longer PFS (3.1 vs 1.8 months, HR 0.46, 0.30-0.71, p<0.001) and OS (6.8 vs 4.5 months, HR 0.56, 0.37-0.85, p=0.006). Patients with ECOG performance status (PS) ≥ 2 at lurbinectedin start, brain or liver metastasis showed a worse outcome. Adverse events were recorded in 218 (92%) patients, with 29% grade 3-4 events.
Conclusion: Considering its safety profile and modest but consistent effectiveness, lurbinectedin represents a therapeutic option as compassionate use in patients with ES-SCLC, especially in those with a long CFI. Poor PS, CFI < 90 days, brain or liver metastases may affect the OS.
European Journal of Cancer , résumé, 2025