SAKK 17/16: Lurbinectedin Monotherapy in Patients with Progressive Malignant Pleural Mesothelioma. A Multicenter, Single-arm Phase II Trial.

Date 20 October 2018
Event ESMO 2018 Congress
Session Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Topics Anticancer Agents
Mesothelioma
Presenter Yannis Metaxas
Citation Annals of Oncology (2018) 29 (suppl_8): viii641-viii644. 10.1093/annonc/mdy301
Authors Y. Metaxas1, A. Xyrafas2, M.T. Mark1, M. Pless3, M. Frueh4, P.R. Froesch5, M. Schneider6, C. Biaggi Rudolf6, F. Grosso7, R. von Moos1
  • 1Oncology/hematology, Kantonsspital Graubünden, 8000 - Chur/CH
  • 2Statistics, SAKK - Swiss Group for Clinical Cancer Research, 3008 - Bern/CH
  • 3Oncology/hematology, Kantonsspital Winterthur, 8401 - Winterthur/CH
  • 4Oncology/hematology, Kantonsspital St. Gallen, 9007 - St. Gallen/CH
  • 5Medical Oncology, IOSI Istituto Oncologico Svizzera Italiana, 6600 - Locarno/CH
  • 6Clinical Trial Management, SAKK - Swiss Group for Clinical Cancer Research, 3008 - Bern/CH
  • 7Oncology/hematology, Ospedale di Alessandria, 15121 - Alessandria/IT

Abstract

Background

Unresectable malignant pleural mesothelioma (MPM) is treated with first-line platinum-based chemotherapy. Unfortunately, there is no standard second-line treatment for progressive patients. As widely available options like gemcitabine and vinorelbine provide only modest efficacy, progressive MPM poses an unmet medical need for further treatment strategies. Lurbinectedin (PM01183) is a novel compound, which covalently binds to the DNA minor groove, inducing double-strand breaks, as well as selectively reducing the tumor-associated macrophages. It has already been tested as monotherapy or in combination with chemotherapy in several Phase I-III trials in different tumor entities (including small cell lung cancer and ovarian cancer) with encouraging results. Based on MPM cases treated with lurbinectedin within the respective Phase I trials, where promising activity had been shown, we are currently conducting this proof-of-concept trial of safety and efficacy of lurbinectedin monotherapy in progressive MPM.

Trial design

This is a prospective 2-stage single-arm multicenter phase II trial. MPM patients progressing after platinum-based chemotherapy with good performance status are eligible for the trial. Prior surgery and/or radiotherapy and pretreatment with immunotherapy are allowed. Treatment will be given with 3.2 mg/m2 lurbinectedin intravenously every 3 weeks (one cycle) until progression, unacceptable toxicity or patient withdrawal. Re-staging using contrast-enhanced computer tomography will be performed every 6 weeks. The primary endpoint of the trial is progression-free survival (PFS) at 12 weeks. Secondary endpoints are PFS, objective response rate, disease control rate at 12 weeks, overall survival, time-to-treatment failure and adverse events. A total of 6 Swiss and 3 Italian sites will participate for a total of 43 patients, as required by Simon’s two-stage design. Accrual has already begun in Switzerland, is expected for February 2018 in Italy, and is estimated to be completed by beginning of 2019. Up to now 11 patients have been treated within the trial.

Clinical trial identification

NCT03213301.

Legal entity responsible for the study

Swiss Group for Clinical Cancer Research (SAKK).

Funding

SAKK, PharmaMar.

Editorial Acknowledgement

Not applicable

Disclosure

All authors have declared no conflicts of interest.