Lurbinectedin is FDA approved for treatment of metastatic small cell lung cancer (SCLC) following progression on or after platinum-based chemotherapy. Prostatic small cell or neuroendocrine carcinoma (SC/NEPC) behaves like SCLC; however, no safety or efficacy data for lurbinectedin in SC/NEPC exists.
All SC/NEPC patients treated with lurbinectedin across 4 academic oncology centers were identified. Baseline patient data and lurbinectedin outcomes including radiographic responses (complete response [CR], partial response [PR], stable disease [SD], progressive disease [PD]), progression free survival (PFS), overall survival (OS), and treatment-related adverse events (trAEs) were described. Clinical benefit rate (CBR) included CR, PR, or SD on imaging. Descriptive statistics were performed.
At first lurbinectedin dose, all 18 patients had metastatic disease. Median age was 63.5 (Range: 53-84), number of prior systemic therapies was 4 (Range: 2-7), and lurbinectedin cycles completed was 5 (Range: 1-10). ADT was administered during lurbinectedin treatment in 9/18 patients. CBR was 9/16 (56%). The most common trAEs were fatigue and anemia. Median OS and PFS were 6.01 (0.23-16.69) and 3.35 (0.16-7.79) months.
Lurbinectedin showed modest but significant clinical benefit in some patients with SC/NEPC and demonstrated an acceptable toxicity profile with no hospitalizations from trAEs. SC/NEPC is an aggressive disease with a poor prognosis for which more treatment options are needed. Evidence for subsequent treatments after platinum-based chemotherapy is lacking. Lurbinectedin is an active treatment option for SC/NEPC; however, larger confirmatory studies are needed.
Clinical genitourinary cancer. 2024 Aug 06 [Epub ahead of print]
Haley Meyer, Rajitha Sunkara, Emily Rothmann, Amar Shah, Irbaz Riaz, Kevin Dale Courtney, Andrew J Armstrong, Andrea Lippucci, Syed Arsalan Ahmed Naqvi, Melissa L Stanton, Himisha Beltran, Alan Haruo Bryce
Department of Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., University of Texas Southwestern Medical Center, Dallas, TX, USA., Duke Cancer Institute Center for Prostate and Urologic Cancer, Duke University, Durham, NC, USA., Department of Pharmacy, Duke University Medical Center, Durham, NC, USA., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Electronic address: ., Department of Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA; Department of Medical Oncology and Developmental Therapeutics, City of Hope Cancer Center, Goodyear, AZ, USA. Electronic address: .