Dr. Melosky on the Use of Lurbinectedin in SCLC

Barbara Melosky, MD, FRCPC, professor of medicine, University of British Columbia, medical oncologist, British Columbia Cancer Center, discusses the use of lurbinectedin (Zepzelca) in small cell lung cancer (SCLC).

The current standard of care for first-line therapy in SCLC is chemotherapy and immunotherapy, Melosky says. When patients progress, second-line options can include topotecan (Hycamtin) or a regimen of cyclophosphamide, doxorubicin, and vincristine, Melosky explains. However, lurbinectedin has emerged as another treatment option in the second-line setting for SCLC, Melosky adds.

Though rechallenging with platinum-based chemotherapy may previously have been the best second-line option, lurbinectedin could represent a better alternative due to the toxicities associated with platinum-based chemotherapy, Melosky continues. Using lurbinectedin as a second-line therapy could also allow for platinum rechallenge as a third-line treatment, Melosky adds.

Regarding topotecan, it is important to consider its adverse effects (AEs), such as marrow toxicity and thrombocytopenia, Melosky adds. Because of these AEs, lurbinectedin presents the best option in the second line, Melosky concludes.