Valentina Boni, MD, PhD, Talks Safety of Lurbinectedin Monotherapy in Pretreated BRCA-Associated Advanced Breast Cancer

Valentina Boni, MD, PhD, of the Early Drug Development Unit at the Universitary Hospital Universitario Quirónsalud Madrid as well as director and principal investigator at NEXT Oncology Madrid in Spain, spoke with CancerNetwork^® at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting about lurbinectedin (Zepzelca) monotherapy for patients with BRCA1/2-associated metastatic breast cancer, which was examined in a phase 2 basket study (NCT02454972). Boni reviewed the safety profile and future promise of this treatment strategy.

Transcript:

The safety profile in this study is very similar to the previously reported safety profile from other studies using lurbinectedin. [A concerning adverse effects] that we saw in the study was grade 3 neutropenia that occurred in 19.0% of the patients, and 23.8% of patients had grade 4 neutropenia, which was also the most common cause of dose reductions. This safety profile is consistent with previously reported studies using lurbinectedin. Neutropenia was quite manageable with dose reductions or with the G-CSF [granulocyte-colony stimulating factor] support.

One of the most interesting fields right now is how we treat patients with an HRD [homologous recombination deficiency] tumor, especially after [disease] progression on platinum [therapy] and PARP inhibitors. Despite the low number of patients included in this arm of the basket trial, the results of these studies are encouraging. Future investigations using lurbinectedin in tumors characterized by a homologous recombination repair deficiency are warranted.

The key message here is that more drugs or investigations for HRD tumors [are needed]. We need better biomarkers for patient selection, but 1 medical need is to expand the therapeutic landscape in this type of tumor that is harboring HRD deficiency. Lurbinectedin will be an alternative in this field. Right now, we need to have more investigation in this field.

Reference

Boni V, Pistilli B, Brana I, et al. Lurbinectedin in patients with pretreated BRCA1/2-associated metastatic breast cancer: Results from a phase II basket study. J Clin Oncol. 2022;40(suppl 16):1092. doi. 10.1200/JCO.2022.40.16_suppl.1092