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Small Cell Lung Cancer: Future Directions in Care

Insights From: Charles Rudin, MD, PhD, Memorial Sloan Kettering Cancer Center
Published: Thursday, Jan 02, 2020



Transcript: 

Charles Rudin, MD, PhD: The treatment of relapsed and refractory small cell lung cancer is really an area of very active investigation right now. There are a number of drugs that we think may have activity there. Their optimal use remains to be defined. One of the agents that has shown activity is an agent called lurbinectedin. This is actually a synthetic derivative of an agent that was initially discovered as a product in the sea sponge that turns out to have anticancer activity. Lurbinectedin has shown evidence of activity in recurrent small cell lung cancer, both as a single agent and when given in combination with doxorubicin, a chemotherapy drug.

Regarding other drugs that I think are of interest in this area that are currently being explored, there have been a number of trials looking at PARP inhibitors. And we think combination of PARP inhibitors with other agents may be quite interesting. Those combinations include combinations with cytotoxic agents, DNA-damaging agents, as well as with immunotherapy. It will be quite interesting to see how those play out. In addition to the PARP inhibitors, there are a number of other agents that target DNA damage-response pathways, which may be a particular area of liability in recurrent small cell lung cancer. All of this is an area of ongoing active exploration.

We’re quite hopeful that we can build on the initial progress that’s been made with the introduction of immunotherapy for this disease. I think that gives us a proof of principle that the immune system can react in a positive way to this disease. I think there are a number of ideas about how to augment that immunotherapy response to make this cold tumor hot—to inflame this tumor and augment the efficacy of immunotherapy. I actually think that may be the most promising avenue of research looking forward 5 or 10 years in the future for small cell lung cancer.

Transcript Edited for Clarity

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Transcript: 

Charles Rudin, MD, PhD: The treatment of relapsed and refractory small cell lung cancer is really an area of very active investigation right now. There are a number of drugs that we think may have activity there. Their optimal use remains to be defined. One of the agents that has shown activity is an agent called lurbinectedin. This is actually a synthetic derivative of an agent that was initially discovered as a product in the sea sponge that turns out to have anticancer activity. Lurbinectedin has shown evidence of activity in recurrent small cell lung cancer, both as a single agent and when given in combination with doxorubicin, a chemotherapy drug.

Regarding other drugs that I think are of interest in this area that are currently being explored, there have been a number of trials looking at PARP inhibitors. And we think combination of PARP inhibitors with other agents may be quite interesting. Those combinations include combinations with cytotoxic agents, DNA-damaging agents, as well as with immunotherapy. It will be quite interesting to see how those play out. In addition to the PARP inhibitors, there are a number of other agents that target DNA damage-response pathways, which may be a particular area of liability in recurrent small cell lung cancer. All of this is an area of ongoing active exploration.

We’re quite hopeful that we can build on the initial progress that’s been made with the introduction of immunotherapy for this disease. I think that gives us a proof of principle that the immune system can react in a positive way to this disease. I think there are a number of ideas about how to augment that immunotherapy response to make this cold tumor hot—to inflame this tumor and augment the efficacy of immunotherapy. I actually think that may be the most promising avenue of research looking forward 5 or 10 years in the future for small cell lung cancer.

Transcript Edited for Clarity
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