Second-Line Sacituzumab Govitecan Shows Promising Efficacy in Extensive-Stage SCLC

More than 40% of patients with extensive-stage small cell lung cancer (ES-SCLC) responded to second-line treatment with sacituzumab govitecan (SG), a Trop-2-directed antibody-drug conjugate, according to updated results from the phase 2 TROPiCS-03 trial presented at the IASLC World Conference on Lung Cancer.

The updated analysis included 43 patients (median age, 67 years) with ES-SCLC who progressed after 1 prior line of platinum-based chemotherapy and anti-programmed death ligand 1 (PD-L1) therapy. Patients received SG 10 mg/kg on days 1 and 8 on a 21-day cycle. Objective response rate (ORR) was the primary endpoint, and secondary endpoints included clinical benefit rate (CBR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety.

The median follow-up was 12.3 months. Of the 43 patients in the extended analysis, 46.5% had platinum-resistant disease, and 16.3% had ongoing treatment.

The ORR for this cohort was 41.9%, with a CBR of 48.8%. The median DOR was 4.73 months (95% CI, 3.52–6.70). Regarding survival, the median PFS was 4.40 months (95% CI, 3.81–6.11) and the median OS was 13.60 months (95% CI, 6.57–14.78). In a subgroup analysis of platinum-resistant and -sensitive patients, the ORRs were 35.0% and 47.8%, respectively.

Most patients (97.7%) experienced any-grade treatment-emergent, treatment-related adverse events (TE TRAE), and in 60.5%, these events were grade 3 or higher. No TE TRAEs led to discontinuation of treatment. There was 1 case of a TE TRAE that led to death (neutropenic sepsis).

“SG as second-line treatment for ES-SCLC demonstrated promising antitumor activity in the fully enrolled ES-SCLC cohort,” the investigators summarized. “This activity was seen in patients with both platinum-resistant and -sensitive disease.” They noted that the safety profile was “manageable and consistent with that observed in other SG studies.”

Reference

Dowlati A, Chiang AC, Cervantes A, et al. Sacituzumab Govitecan as Second-Line Treatment in Patients with Extensive Stage Small Cell Lung Cancer. Abstract OA04.04. Presented at the IASLC World Conference on Lung Cancer; September 7-10, 2024; San Diego, California.