Dr Apar Kishor Ganti on How Lurbinectedin Improves Outcomes in SCLC

November 13, 2020

Small cell lung cancer is an aggressive disease that has had few treatment options before lurbinectedin, said Apar Kishor Ganti, MD, professor of internal medicine, Division of Oncology & Hematology, University of Nebraska Medical Center.

Small cell lung cancer is an aggressive disease that has had few treatment options; however, a larger proportion of patients are responding to lurbinectedin, making it a good, new option, said Apar Kishor Ganti, MD, professor of internal medicine, Division of Oncology & Hematology, University of Nebraska Medical Center.

Why is small cell lung cancer so aggressive, and why is lurbinectedin effective after chemotherapy for these patients?

Small cell lung cancer in general is a very aggressive disease. And even though initially it responds very well to chemotherapy, better than a lot of other tumors, these patients almost invariably relapse. And the exact reasons as to why this happens is not known. But there are multiple theories, one of which is suggests that there is a group of cells that are hidden or do not get exposed to the previous treatments, and they then start growing rapidly and…cause relapse.

It is a fairly aggressive disease, also because it has a lot of intracellular processes that go on and we have still don't understand them completely. But what we do know is patients who have relapsed don't tend to respond to multiple other treatments or any other treatments. If you look at it, multiple different treatments have been studied in this setting, and across the board the median progression-free survival seems to be anywhere between 2 and 3 months. And the median overall survival seems to be anywhere between 6 to 9 months. So, not great treatment options.

And in that setting, when you have a larger proportion of patients responding, like we see with lurbinectedin, it automatically becomes a good treatment option. It's almost like we've been looking for some treatment options for this group of patients for a long time.

What is the importance of lurbinectedin being available in an outpatient clinic?

Most of these patients are treated in the outpatient setting, given the nature of how we see our patients and how these patients present. And so, it's important to have it in the outpatient setting. Because that's where the majority, the vast majority, of these patients are treated.