Published in Oncology
Expert Opinion / Interview · June 11, 2019
Lurbinectedin for Second Line Treatment of Small Cell Lung Cancer
- Interview with
Wade T Iams MD- Interview by
Farzanna S Haffizulla MD, FACP, FAMWA
Dr. Farzanna Haffizulla:
Thank you for joining us for another edition of Practice Update. I’m your host, Dr. Farzanna Haffizulla. Joining me today is Dr. Wade Iams. Great to have you here.
Dr. Wade Iams:
Good to be here. Thanks for having me.
Dr. Farzanna Haffizulla:
Excellent. So, we’re here at ASCO 2019 in Chicago. We know there are many interesting presentations, but there is one on small cell cancer at the conference that looks at the agent lurbinectedin. Can you tell us about this drug and how it’s designed to work?
Dr. Wade Iams:
Lurbinectedin binds to the minor groove of DNA and prevents DNA replication, also prevents DNA synthesis, results in double-stranded DNA breaks and ultimately apoptosis.
Dr. Farzanna Haffizulla:
So let’s go back to the actual trial itself. Can you tell us about the patient population that was targeted in this trial?
Dr. Wade Iams:
So lurbinectedin is being reported in patients only in the second line setting with small cell lung cancer, both platinum-sensitive and platinum-resistant disease defined as whether a patient has recurrence of small cell lung cancer within 90 days of platinum treatment so second line only in small cell lung cancer patients.
Dr. Farzanna Haffizulla:
Good to know. Tell us more about the study design itself.
Dr. Wade Iams:
So, this was a multi-center, actually non-randomized trial and the small cell lung cancer cohort was one of several different histologies included, but the ASCO 2019 report is on the small cell lung cancer cohort.
Dr. Farzanna Haffizulla:
I see. How active does lurbinectedin appear in this particular setting?
Dr. Wade Iams:
Positive results I would say in the context of historical data, it wasn’t a randomized trial but the overall response rate of the trial was 35% in patients with a difficult-to-treat malignancy after recurrence distinguished by the platinum-sensitive and the platinum-refractory patients, the platinum-sensitive patients had a higher response rate on the order of 45% or a little over 45% response rate, which is very good historically and the platinum-refractory patients were closer to 20% to 21% response rate.
Dr. Farzanna Haffizulla:
Excellent. Well, do you anticipate that this might become a standard treatment option in the future?
Dr. Wade Iams:
Really good question, the most important question. I have to say I don’t know, I don’t want to preclude the FDA’s review of the data, but it’s certainly promising in the historical context where 20% to 30% at best response rates are achieved in this patient population so it’s looking good.
Dr. Farzanna Haffizulla:
Excellent. Well, thank you so much for sharing that with us.
Dr. Wade Iams:
Thank you.