ESMO Congress 2023 | OncologyPRO

Abstract 2024P

Background

Chemotherapy-induced myelosuppression (CIM) has an important impact on patients with Small Cell Lung Cancer (SCLC) and Health Systems. Granulocyte colony-stimulating factors (G-CSF), platelet and red blood cell (RBC) transfusions or erythropoiesis-stimulating agents (EPO) are standard treatments. Trilaciclib is indicated to decrease the incidence of CIM when administered before topotecan. The occurrence of CIM events with standard of care (SoC) chemotherapies for relapsed SCLC and supportive care interventions were investigated.

Methods

Inputs were obtained from clinical trials with lurbinectedin (Basket NCT02454972), topotecan after trilaciclib or placebo (NCT02514447), CAV and topotecan (ATLANTIS, NCT02566993) that reported key measures of CIM and supportive care. Therapies were offered mainly as 2L. Cost analysis was performed for grade ≥3 events. Unit costs were obtained from the Spanish Minimum Basic Data Set (€, 2023).

Results

Patients treated with lurbinectedin experienced fewer CIM events than those treated with topotecan, either with or without prior administration of trilaciclib, or with CAV and require less supportive treatments (Table). Lurbinectedin would reduce costs of managing CIM events by 43% - 69% (58% compared to trilaciclib followed by topotecan). Table: 2024P

	Lurbinectedin*N=105	Trilaciclib prior to topotecan iv*N=32	Placebo prior to topotecan iv*N=29	CAV (ATLANTIS)**N=168	Topotecan iv (ATLANTIS)**N=121
Neutropenia ≥3	46.7%	68.8%	85.7%	66.1%	73.6%
Severe Neutropenia	24.8%	40.6%	75.9%	54.2%	50.4%
Anaemia ≥3	10.5%	28.1%	60.7%	26.2%	54.5%
Thrombocytopenia ≥3	6.07%	51%	57.2%	17.9%	49.6%
FN	4.8%	6.3%	17.9%	10.1%	5.8%
G-CSF therapeutic	21.9%	50.0%	65.5%	30.4%	19.0%
Platelet transfusions	4.8%	25%	31%	3.6%	21.5%
RBC transfusions	10.5%	31.3%	41.4%	18.5%	46.3%
EPO	1.9%	3.1%	20.7%	9.5%	8.3%

∗ Prophylactic G-CSF not allowed ∗∗ Primary prophylaxis with G-CSF with 100% of patients

Conclusions

Patients with relapsed SCLC treated with lurbinectedin require fewer resources and less cost for managing CIM episodes than other SoC, including topotecan with prior trilaciclib, based on clinical trials.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

PharmaMar.

Funding

PharmaMar.

Disclosure

B. García San Andres: Financial Interests, Personal, Other, employee: PharmaMar. J. Gómez, J. Iglesias: Financial Interests, Personal, Stocks or ownership: PharmaMar. B. Citoler, M. Prades: Financial Interests, Institutional, Advisory Role: Outcomes 10. All other authors have declared no conflicts of interest.