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Lurbinectedin, a novel selective inhibitor of oncogenic transcription, has been investigated for its efficacy in comparison to standard chemotherapy. A recent study published in the Annals of Oncology evaluated the efficacy and safety of lurbinectedin in patients with small cell lung cancer (SCLC) who had progressed after prior platinum-based chemotherapy [1].

In this phase II basket trial, lurbinectedin demonstrated an overall response rate (ORR) of 35.2% and a disease control rate (DCR) of 67.6% in SCLC patients. The median progression-free survival (PFS) was 3.9 months, and the median overall survival (OS) was 9.3 months [1]. These results were considered promising, as they compared favorably to historical data for second-line treatments in SCLC [1].

When comparing lurbinectedin's efficacy to standard chemotherapy, it is important to consider the toxicity profiles of both treatment options. The most common grade 3 or higher adverse events (AEs) associated with lurbinectedin were neutropenia (39.6%), anemia (15.2%), thrombocytopenia (12.1%), and fatigue (10.5%) [1]. These AEs are generally consistent with those observed in standard chemotherapy regimens for SCLC, such as topotecan or cyclophosphamide, doxorubicin, and vincristine (CAV) [2].

However, direct comparisons of lurbinectedin and standard chemotherapy are limited, as no head-to-head clinical trials have been conducted to date. Therefore, while lurbinectedin has shown promise in treating SCLC patients who have progressed after prior platinum-based chemotherapy, more research is needed to establish its comparative effectiveness relative to standard chemotherapy regimens.

In summary, lurbinectedin has demonstrated encouraging efficacy and safety profiles in SCLC patients who have progressed after prior platinum-based chemotherapy. Its efficacy appears comparable to standard chemotherapy, but direct comparisons are limited. Further research is required to establish the relative effectiveness of lurbinectedin and standard chemotherapy regimens in treating SCLC.

Sources:
[1] Trigo, J., Subbiah, V., Besse, B., et al. (2021). Lurbinectedin in patients with relapsed small-cell lung cancer: a phase 2, open-label, single-arm, multicentre, basket trial. Annals of Oncology, 32(5), 637–647. <https://doi.org/10.1016/j.annonc.2021.02.001>
[2] National Comprehensive Cancer Network. (2021). NCCN Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer, Version 2.2021. <https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf>
[3] DrugPatentWatch. (n.d.). Lurbinectedin (PMID20627432). <https://www.drugpatentwatch.com/drugs/lurbinectedin>