Though there are many presentations to discuss in the wake of ASCO, we’ll need to pace ourselves on these. I and some of the other faculty members will offer thoughts on some of these in the coming weeks, and we also have our upcoming post-ASCO review on June 23rd (click here to learn more and sign up for this free online program).
Today we saw the results of a couple of long-awaited trials of treatment approaches that represented a couple of the more promising concepts for moving forward in our treatment of extensive SCLC, and I’ll cover the first of these today (though only with the benefit of my notes, rather than as many details as I’d like, so these comments are subject to revision and added details later). Amrubicin has been the subject of some prior discussion here, but that discussion focused on smaller, phase II trials; we’ve needed the results of a randomized phase III trial that directly compares the chemo agent amrubicin as a single agent to our current standard for Hycamtin (topotecan). The ACT-1 trial in enrolled 637 patients with extensive disease SCLC who had all received first line therapy and then relapsed — the trial included patients who had a “sensitive” relapse, 3 or more months after prior chemo had ended, as well as “resistant” relapse, which is marked by progression within 3 months of prior chemo ending (pretty evenly split at nearly 50/50 on the trial). Patients were randomized 2:1 to either amrubicin at 40 mg/m2 IV on days 1-3 of a 21 day cycle, or topotecan at 1.5 mg/m2 IV days 1-5 of a 21 day cycle.





