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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Friday, September 13, 2024
Second- or third-line treatment with the selective immunomodulating microtubule-binding agent plinabulin plus docetaxel appeared to be safe and active in patients with EGFR wild-type advanced or metastatic platinum-refractory non–small cell lung cancer (NSCLC), according to Trevor Feinstein, MD, of Piedmont Cancer Institute, Atlanta, and colleagues. These findings from the final analysis of the multicenter phase III DUBLIN-3 trial were presented during the International Association for the Study of Lung Cancer (IASLC) 2024 World Conference on Lung Cancer (WCLC; Abstract OA08.04).
Patients were randomly assigned to receive docetaxel plus either plinabulin (n = 278) or a placebo (n = 281). Plinabulin was found to significantly improve overall survival (hazard ratio [HR] = 0.82). The median durations with plinabulin and the placebo were 10.5 and 9.4 months, respectively. According to the investigators, with an additional 24-month follow-up after database lock, the overall survival benefit was sustained in the intention-to-treat population; the median duration appeared to significantly favor plinabulin (10.8 vs 9.3 months; HR = 0.81), especially in patients with nonsquamous histology (11.4 vs 8.8 months; HR = 0.72). Overall survival benefits with plinabulin were observed with more treatment cycles, which the investigators believe suggests durable anticancer activity.
A significantly higher objective response rate was reported with plinabulin vs the placebo, with 14.0% vs 8.5% of patients achieving a partial response, respectively. Treatment with plinabulin also showed a significantly longer median progression-free survival (3.3 vs 2.8 months; HR = 0.79).
According to the investigators, plinabulin significantly reduced the rate of grade 4 neutropenia from 27.8% to 5.3%. Treatment-emergent adverse events were reported in 99.6% of patients treated with plinabulin and 99.3% of those who received the placebo. The rates of grade 3 and 4 gastrointestinal disorders (16.8% vs 2.9%) and transient grade 3 hypertension (18.2% vs 2.9%) were higher with plinabulin.
Disclosure: For full disclosure information, visit wclc2024.iaslc.org.
2024 World Conference on Lung Cancer
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