2024 World Conference on Lung Cancer (WCLC) - Posters-P1.13B.01 Lurbinectedin vs. Platinum Rechallenge in Extensive Stage Small Cell Lung Cancer after Platinum Doublet, A Multicenter Retrospective Study

P1.13B.01 Lurbinectedin vs. Platinum Rechallenge in Extensive Stage Small Cell Lung Cancer after Platinum Doublet, A Multicenter Retrospective Study

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The study investigates second-line treatment options for extensive-stage small cell lung cancer (ES-SCLC) following initial platinum-based chemotherapy. Despite an initial strong response to first-line platinum doublet chemotherapy, patients often relapse quickly, and the optimal second-line treatment remains unclear. This multicenter retrospective cohort study compared the efficacy of lurbinectedin versus platinum doublet rechallenge in a real-world setting.<br /><br />Patients were selected from records at the Vanderbilt Ingram Cancer Center and the University of Pennsylvania, covering the years 2000 to 2023. The primary outcomes were overall survival (OS) and real-world progression-free survival (rwPFS), alongside secondary outcomes like safety and tolerability.<br /><br />Results showed no significant difference in OS and rwPFS between patients treated with lurbinectedin and those who underwent platinum doublet rechallenge. A Cox proportional hazard analysis adjusted for chemotherapy-free interval (CTFI) and concurrent immunotherapy indicated hazard ratios for lurbinectedin versus platinum rechallenge were 1.94 for OS and 1.55 for rwPFS, demonstrating no significant survival benefit for lurbinectedin.<br /><br />When stratifying patients based on their CTFI before starting second-line therapy (less than 3 months, 3-6 months, and over 6 months), median OS and rwPFS showed no notable differences between the treatments. Safety profiles were similar, but platinum-based chemotherapy had higher discontinuation rates due to tolerability issues.<br /><br />The findings suggest no clear survival advantage of one treatment over the other, though lurbinectedin might offer similar outcomes with potentially better tolerability than platinum rechallenge. Further research is needed to identify appropriate second-line treatments for different patient CTFI subgroups in ES-SCLC.

Asset Subtitle

Michael Libre

Meta Tag

Speaker Michael Libre

Topic SCLC & Neuroendocrine Tumors

Keywords

extensive-stage small cell lung cancer

ES-SCLC

second-line treatment

platinum-based chemotherapy

lurbinectedin

platinum doublet rechallenge

overall survival

progression-free survival

chemotherapy-free interval

tolerability