Ariel Lopez-Chavez, MD, discusses the current approach to managing recurrent small cell lung cancer especially in patients who have progressed after first-line chemotherapy.
Ariel Lopez-Chavez, MD, medical oncologist, director of precision medicine and developmental therapeutics at Allegheny Health Network Cancer Institute, discusses the current approach to managing recurrent small cell lung cancer (SCLC), especially in patients who have progressed after first-line chemotherapy.
Here, he highlights some advancements in the field and their promise as they introduce additional options for managing recurrent SCLC with potentially improved patient outcomes.
Transcription:
0:09 | For years, the only things we had were topotecan and irinotecan, but as of May of 2020, we got the approval of lurbinectedin [Zepzelca]. Then more recently, we got the approval of tarlatamab in the second-line setting. Now, we have 4 agents. The use of these agents has been shifting to the newer agents, lurbinectedin and tarlatamab[-dlle (Imdelltra)], because they have a better toxicity profile. It is very exciting to have more agents in this space now. The question [now] will be what to choose, in particular, between lurbinectedin and tarlatamab. How do we choose between these 2 agents, which are very different? They have different toxicity profiles, and they have different mechanisms of actions.
1:20 | The other interesting facts on how to use them is that there are trials moving them into an earlier space, into the maintenance setting. IMforte [NCT05091567] is a trial of lurbinectedin in combination with atezolizumab after induction with chemotherapy and atezolizumab. If that is a positive trial, then the question would be, are people going to treat first with lurbinectedin in the maintenance setting and when they progress, use tarlatamab in the second line? We also have the DeLLphi-305 trial [NCT06211036] in which then tarlatamab is moving into the maintenance setting. If that turns out to be positive, then we will have 2 agents there in the maintenance setting. Then, we are back at how to choose between those 2 agents, so this is going to be an interesting story.