Summary of Neil Love small cell lung cancer edition 8/2020

http://m.researchtopractice.com/OncologyTodaySCLC20/Video?playlistIndex=0#t=0m0s
Oncology Today with Dr Neil Love: Small Cell Lung Cancer Edition (Video Program) with Dr. Charles Rudin from MSK
8/2020, short 30min:
Discussion points:
1. Given the use of IO in the 1st line therapy for SCLC, what do we do with the 3rd line approval (7:10): Durable response in only 10%. Dr. Rubin would consider ipi/nivo for pts who previously had PD-L1 ab in the front-line
2. New agents/trials in SCLC: TIGIT, NK cells, Macrophages
1). subtype defined by transcriptional profiling: YAP1 subtype-immune "inflammed"?, ASCL1, Rudin Nat Rev 2019
2). Targeting the CD47 "don't-eat-me" signal, preclinical data in SCLC
3) PARPi and PD-1 blockade: Durv+olaparibi, not very impressive
4. Lurbinectedin: Alkylator, tumor intrinsic effects, turns off transcription factors, tumor associated macrophage effect. Single arm phase II, ORR 35%, OS 9.3m. Less heme SAE compared to topotecan
5. Deficiency in P53 and RB in SCLC
6. Epigenetic targeting: EZH2, LSD1, BRD4, AMG757 BiTE for DLL3
7. Consolidation chest radiation for ES SCLC: if limited residual disease in the chest, is to be considered. PCI not favored in ES
8. Screening detected early stage SCLC (T1bN0M0), s/p resection, Dr. Rubin would offer cisplatin/etoposide x 4 as adjuvant therapy, retrospective study showed benefit, lacking prospective data. 

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