The following article features coverage from the IASLC 2021 World Conference on Lung Cancer. Click here to read more of Cancer Therapy Advisor’s conference coverage.

Combination lurbinectedin and doxorubicin did not improve overall survival (OS) in patients with relapsed small-cell lung cancer (SCLC), according to trial results presented at the IASLC 2021 World Conference on Lung Cancer (WCLC).

The phase 3 ATLANTIS trial ( Identifier: NCT02566993) was designed to compare lurbinectedin plus doxorubicin with cyclophosphamide, doxorubicin, and vincristine (CAV) or topotecan in patients with SCLC.

Enrolled patients had limited- or extensive-stage SCLC, had progressed on 1 previous line of platinum chemotherapy, had a chemotherapy-free interval (CTFI) of 30 days or more, and had an Eastern Cooperative Oncology Group performance status of 2 or less.

Continue Reading

The patients were randomly assigned to receive lurbinectedin plus doxorubicin (307 patients) or CAV/topotecan (306 patients) until disease progression or unacceptable toxicity. Baseline characteristics — including age, gender, and smoking status — were well balanced between the treatment arms.

The study’s primary endpoint was OS. In the intention-to-treat population, the median OS was 8.6 months in the lurbinectedin arm and 7.6 months in the control arm (hazard ratio [HR], 0.967; P =.7032).

None of the variables used for stratification — including CTFI after first-line treatment, performance status, and baseline central nervous system involvement — predicted superior OS in either treatment arm.

The median progression-free survival (PFS) was 4.0 months in each arm, but there was a significant difference in favor of the lurbinectedin arm (HR, 0.831; P =.0437). The 12-month PFS rate was 10.8% in the lurbinectedin arm and 4.4% in the control arm (P =.0129).

PFS was superior in the lurbinectedin arm among patients with a CTFI after first-line treatment of at least 180 days (HR, 0.469) and among patients with no baseline central nervous system involvement (HR, 0.788).

The overall response rate was 31.6% in the lurbinectedin arm and 29.7% in the control arm. The median duration of response was 5.7 months and 3.8 months, respectively (HR, 0.581; P =.0012).

Patients in the control arm were more likely to have grade 3 or higher adverse events than those in the lurbinectedin arm — 75.4% and 47.2%, respectively — as well as an adverse event leading to death — 3.5% and 0.3%, respectively.

Disclosures: This research was supported by PharmaMar. One study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Read more of Cancer Therapy Advisor’s coverage of WCLC 2021 by visiting the conference page.


Paz-Ares L, Ciuleanu TE, Navarro A, et al. Lurbinectedin/doxorubicin versus CAV or topotecan in relapsed SCLC patients: Phase III randomized ATLANTIS trial. Presented at: IASLC 2021 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer; September 8-14, 2021; Abstract PL02.03.