Outcome and safety of lurbinectedin as compassionate use in extensive stage small cell lung cancer: A multicentric international cohort

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.