Researchers have created a new compound that could potentially help mesothelioma patients. Lurbinectedin is a synthetic material that can stop the growth of mesothelioma and other cancers. It works by blocking cytokine transcription in tumor cells. Cytokine transcription is the copying of DNA to allow the passing of the genetic information out of the cell. It is showing promising results as a second line treatment for mesothelioma patients whose cancer has progressed and come back after surgery. In earlier clinical trials the treatment was shown to be very effective. The later clinical trials are to see how safe and effective the treatment is for mesothelioma.
The trial occurred in Switzerland and Italy and used 42 patients with different types of mesothelioma. There were 33 epithelioid, 4 biphasic, and 5 sarcomatoid patients. After patients received first line pemetrexed chemotherapy or immunotherapy they received third line lurbinectedin. Lurbinectedin with a concentration of 3.2 mg/m2 was given intravenously until the disease progressed or there was an unacceptable level of toxicity. Progression free survival at 12 weeks was the primary endpoint and if at least 21 patients achieved this the goal would be considered met.
All patients had their disease progress after first line treatment. The typical median overall-survival for mesothelioma patients is between 6 and 9 months but with the lurbinectedin the median overall survival was 11.9 months. This is a significant change for such a devastating disease. The median progression-free survival is two months for typical second and third line treatments but during the study the median progression-free survival was 4.1 months. Thirty-three patients saw grade 3-4 toxicity. Leuco-lumphopenia was in 60.6 percent of the 33 patients, fatigue was in 24.2 percent of the 33 patients, and febrile neutropenia was in 9.1 percent of the 33 patients. None of the patients ended their treatment because of the toxicity.
The next step for lurbinectedin is a randomized trial. Data from a randomized trial needs to be compared with the results seen in this trial. Without this data, doctors will not know how effective the treatment is and cannot actually use it on patients. With a more randomized dataset, doctors can actually see how many patients benefit from the treatment and get an accurate representation of how well the treatment works.
Sources:
“Lurbinectedin data in Progressive Malignant Pleural Mesothelioma presented at ESMO” BioSpace (October 1, 2019). [Link]
“SAKK 17/16: Lurbinectedin as second or third line palliative chemotherapy in malignant pleural mesothelioma (MPM)” Oncology Pro (September 30, 2019). [Link]