Shim Joo Sung, Kim Youhyun, Yuh Taeho, Lee Jii Bum, Kim Hye Ryun, Hong Min Hee, Cho Byoung Chul, Lim Sun Min
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
Lung Cancer (Auckl). 2024 Oct 30;15:149-159. doi: 10.2147/LCTT.S485320. eCollection 2024.
Small-cell lung cancer (SCLC) accounts for approximately 10-15% of all lung cancers and is characterized by a high recurrence rate, early metastasis, and poor prognosis. Before the FDA approved lurbinectedin for SCLC that progressed on or after platinum-based chemotherapy in 2020, topotecan was the sole second-line option associated with hematological toxicities and modest efficacy. Lurbinectedin received conditional approval in Korea in September 2022 for metastatic SCLC progression, with the same indications. Real-world data on its efficacy remains scarce owing to its recent implementation.
Patients with metastatic SCLC who progressed on or after first-line therapy (n = 51) at Yonsei Cancer Center, Seoul, received lurbinectedin at 3.2 mg/m². Efficacy data, including tumor response, progression, survival, and demographics, were recorded.
A total of fifty-one patients received lurbinectedin between April 2023 and March 2024, with thirty-four patients being eligible for the assessment. At diagnosis, approximately one-third of the patients were female, 3% had a poor performance status with an Eastern Cooperative Oncology Group Performance Score (ECOG PS ≥ 2), and the median age was 68. Most patients (80%) had extensive disease. Overall objective response rate (ORR) and disease control rate (DCR) were 20% and 47%, respectively. The median progression-free survival (PFS) was 2.8 months, and the median overall survival (OS) was 3.3 months. Never smokers showed prolonged OS compared with current/former smokers (Smokers; 3.0 vs 7.3 months). Common adverse effects were nausea (53%), loss of appetite (24%), general weakness (18%), anemia (29%), neutropenia (12%), dizziness (6%), alopecia (6%), thrombocytopenia (3%), and pneumonia (3%). Overall, 24% of the patients experienced grade ≥3 adverse events (AEs), with the most common being anemia (9%) and neutropenia (9%).
Real-world data suggest that lurbinectedin is a viable option for patients with SCLC who have progressed on or after platinum-based chemotherapy.
小细胞肺癌（SCLC）约占所有肺癌的10 - 15%，其特点是复发率高、早期转移且预后不良。在2020年美国食品药品监督管理局（FDA）批准鲁比卡丁用于铂类化疗后进展的小细胞肺癌之前，拓扑替康是唯一与血液学毒性和中等疗效相关的二线选择。鲁比卡丁于2022年9月在韩国获得有条件批准，用于转移性小细胞肺癌进展，适应症相同。由于其近期才应用，关于其疗效的真实世界数据仍然稀缺。
首尔延世癌症中心一线治疗后进展的转移性小细胞肺癌患者（n = 51）接受3.2 mg/m²的鲁比卡丁治疗。记录疗效数据，包括肿瘤反应、进展、生存情况和人口统计学数据。
2023年4月至2024年3月期间，共有51例患者接受了鲁比卡丁治疗，其中34例患者符合评估条件。诊断时，约三分之一的患者为女性，3%的患者 Eastern 肿瘤协作组体能状态评分（ECOG PS≥2）较差，中位年龄为68岁。大多数患者（80%）患有广泛期疾病。总体客观缓解率（ORR）和疾病控制率（DCR）分别为20%和47%。中位无进展生存期（PFS）为2.8个月，中位总生存期（OS）为3.3个月。从不吸烟者与目前/既往吸烟者相比，总生存期延长（吸烟者：3.0个月 vs 7.3个月）。常见不良反应包括恶心（53%）、食欲减退（24%）、全身乏力（18%）、贫血（29%）、中性粒细胞减少（12%）、头晕（6%）、脱发（6%）、血小板减少（3%）和肺炎（3%）。总体而言，24%的患者发生≥3级不良事件（AE），最常见的是贫血（9%）和中性粒细胞减少（9%）。
真实世界数据表明，鲁比卡丁对于铂类化疗后进展的小细胞肺癌患者是一种可行的选择。
