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]