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SCLC: Lurbinectedin vs Topotecan - 2nd-line


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I completed my layman's comparison of Lubinectedin vs Topotecan this morning. I compared data from the recent Lurbinectedin phase II trial and a 2015 Scientific Reports pooled systematic review of Topotecan [Scientific Reports 5:15437 DOI: 10.1038/srep15437]. In my untrained opinion, Lurbinectedin beats Topotecan easily for 2nd-line treatment! My comparison data is shown below. Please research definitions of acronyms in the NCI dictionary. Comparison order of numbers will be Lurbinectedin vs Topotecan.

OS 6mos (refractory): 61.9% to 37%

OS 1yr (refractory): 22.9% to 9%

OS 6mos (sensitive): 92.7% to 57%

OS 1yr (sensitive): 59.1% to 27%

DCR (refractory): 61% to 29%

DCR (sensitive): 79% to 42%

PR (refractory): 33.3% to 3%

PR (sensitive): 44.4% to 14%

PD (refractory): 37% to 59%

PD (sensitive): 17.6% to 48%

AE (grade 3/4): 34.3% to 69%

OS (mos): 9.3 to 5.8

PFS (mos): 3.9 to 3.9

ORR: 35.2% to 24%

Refractory vs sensitive is disease recurrence < vs > 3 months after 1st-line treatment. OS is overall survival; DCR is disease control rate; PR is partial response; PD is progressive disease; AE is adverse event; PFS is progression-free survival; and ORR is overall response rate.

An oncologist should be able to explain the comparison and whether it is valid, since the data is not "head-to-head". Let's hope the drug Lurbinectedin becomes available soon.



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