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Lurbinectedin shows clinical activity and immune-modulatory functions in patients with pre-treated small cell lung cancer and malignant pleural mesothelioma

  • Daphne W. Dumoulin
  • , Luca Cantini
  • , Robin Cornelissen
  • , Madelief Vink
  • , Larissa Klaase
  • , Kick Sloof
  • , Nura Tebayna
  • , Joanne M. Mankor
  • , Sara J. Baart
  • , Rudi Hendriks
  • , Anne-Marie C. Dingemans
  • , Marcella Willemsen
  • , Joachim G. J. V. Aerts*
  • *Corresponding author for this work
  • Erasmus University Rotterdam
  • Marche Polytechnic University
  • Erasmus MC

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: Lurbinectedin is a promising new drug being investigated in pre-treated patients with small cell lung cancer (SCLC) or malignant pleural mesothelioma (MPM). Its clinical activity in the real-world setting has not been investigated yet. Patients and methods: Clinical data of patients with SCLC and MPM who were treated with lurbinectedin were prospectively collected. Comprehensive immune cell profiling by flow cytometry was performed on screening and treating peripheral blood samples. Results: A total of 95 patients (43 SCLC and 52 MPM) were treated, mostly as ≥3-line of therapy. In the SCLC cohort, a median progression-free survival (mPFS) was 1.5 months (95% CI: 1.4–3.0), and median overall survival was 7.0 months (95% CI: 4.7–not reached). Objective radiological response and disease control rate after 12 weeks were 16% and 28%, respectively. In the MPM cohort, median progression-free survival was 2.8 months (95% CI: 1.4–4.2), and median overall survival was 7.2 months (95% CI: 5.9–not reached). Disease control rate after 12 weeks was 29%, whereas no partial responses were registered. No new safety signals were observed. Lurbinectedin treatment was significantly associated with the depletion of circulating classical monocytes, which correlated with a better PFS in patients with SCLC. Lurbinectedin increased the proliferation of CD4+ and CD8+ T cells (SCLC) and natural killer and natural killer T cells (SCLC and MPM) and altered co-stimulatory and co-inhibitory receptor expression on circulating lymphocytes. Conclusion: Lurbinectedin has a manageable safety profile and shows clinical activity in pre-treated patients with SCLC and MPM. Its immune-modulatory functions make lurbinectedin a potential platform for immunotherapy combinations.
Original languageEnglish
Pages (from-to)357-366
Number of pages10
JournalEuropean Journal of Cancer
Volume172
DOIs
Publication statusPublished - 1 Sept 2022
Externally publishedYes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • Lurbinectedin
  • immune monitoring
  • immunotherapy
  • malignant pleural mesothelioma/MPM
  • small cell lung cancer/SCLC

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