Second‐line lurbinectedin as a new treatment option for small‐cell lung cancer: Preliminary results in real‐clinical practice

INTRODUCTION: Few strategies exist for treatment of patients with small‐cell lung cancer (SCLC) extended‐stage after failure of first‐line platinum‐based chemotherapy. Lurbinectedin is a novel RNA‐polymerase‐II inhibitor investigated as a second‐line therapy for SCLC. However, its efficacy and safety profile in real clinical practice remain to be determined. OBJECTIVE: To determine the efficacy and safety of lurbinectedin in real‐life among patients with SCLC previously treated with first‐line platinum‐based chemotherapy. METHODS: We retrospectively evaluated patients who received at least one dose of lurbinectedin (3.2 mg/m(2)) between March 2020 and November 2021, in the pulmonary department of Bordeaux University Hospital. Endpoints were time to treatment discontinuation, progression‐free survival, overall survival, and safety profile. RESULTS: Thirteen patients were included. The median age was 60 years (range: 42–77), seven (54%) were females, nine (69%) having a performance status of 0–1. Lurbinectedin was given as second‐line treatment before platinum rechallenge in four (31%) patients. After a mean follow‐up of 4.1 months, the objective response rate (ORR) was 17%. The median time to treatment discontinuation (TTD) was 2.3 months (interquartile range [IQR], 1.2–3.6). The median progression‐free survival (PFS) and overall survival (OS) were, respectively, 1.9 (IQR, 0.1.8) and 4.1 (IQR, 2.0–3.5) months. No significant difference regarding TTD, PFS or OS was found in the two groups according to treatment history or according to chemotherapy‐free intervall (CMI) 〈1 or 〉1 month. The most common adverse events (AEs) were asthenia, nausea, and anemia in nine (70%) patients. Grade 3 AEs were reported, fatigue, vomiting, nausea, anorexia, and neutropenia. CONCLUSIONS: Lurbinectedin in real clinical practice could have had a lower efficacy than in phase II trial, but a better hematological and bioclinical tolerance than previously reported. Early relapse after platinum‐based chemotherapy seems to have a lower response to lurbinectedin.