Etirinotecan pegol does not improve the overall survival of people with breast cancer and stable brain metastases relative to physicians’ choice of single-agent chemotherapy, show trial data.

He continued: “Novel combinations of lurbinectedin with other cytotoxics such as irinotecan or checkpoint inhibitors such as atezolizumab are being explored.”

Progression-free survival (PFS) was greatest with bevacizumab plus etoposide and platinum-based chemotherapy, at a significant HR of 1.54 relative to etoposide–platinum chemotherapy alone, while the HR for irinotecan–platinum chemotherapy was a significant 1.30 versus etoposide and platinum-based chemotherapy.

The drug element, SN-38, is a metabolite of the topoisomerase I inhibitor irinotecan and is more potent than the parent compound.

Sacituzumab govitecan is a Trop-2-directed antibody conjugated to SN-38, an active metabolite of the topoisomerase I inhibitor irinotecan.

This is a phase II/III trial of an injectable liposomal formulation of irinotecan in individuals who have progressed during or after initial treatment with platinum-based chemotherapy.

In the phase III trial – which investigated the addition of irinotecan to fluorouracil plus leucovorin – the incidence of any-grade or grade 3 or 4 alopecia, stomatitis, diarrhea, nausea, leukopenia, neutropenia, and anemia was significantly higher among female participants (n=1318; 44.3%) than their male counterparts (n=1656; 55.7%) when the study arms were pooled.

The patients were randomly assigned to receive treatment with mXELIRI (capecitabine plus irinotecan; n=326) or FOLFIRI (leucovorin, fluorouracil, and irinotecan; n=324), with approximately 83% in each group also being treated with concurrent bevacizumab.

Participants were randomly assigned to receive mFOLFIRINOX – comprising fluorouracil 2.4 mg/m 2 over 46 hours, oxaliplatin 85 mg/m 2 , leucovorin 400 mg/m 2 plus irinotecan 150–180 mg/m 2 – every 2 weeks for up to 12 cycles, or gemcitabine at a dose of 1000 mg/m 2 every 3 or 4 weeks for a maximum of six cycles.

Overall, 136 (70.5%) of 193 patients (mean age 64 years, 49.7% women) with borderline resectable or locally advanced pancreatic cancer underwent resection following neoadjuvant therapy, typically with fluorouracil, irinotecan, oxaliplatin, leucovorin, and folic acid (64.2%).

The patients received eight cycles of FOLFIRINOX (fluorouracil, irinotecan, and oxaliplatin) followed by short-course chemoradiotherapy (25.0 Gy in five fractions with protons or 30.0 Gy in 10 fractions with photons) with capecitabine for patients with resolution of vascular involvement upon restaging (n=27) or by long-course chemoradiotherapy (50.4 GY in 28 fractions) with fluorouracil or capecitabine for those with persistent vascular involvement (n=17).

Second-line therapy of metastatic CRC that has progressed after first-line treatment with regimen containing a bevacizumab product; to be given together with chemotherapy containing fluoropyrimidine–irinotecan or fluoropyrimidine–oxaliplatin.

The treatment may be used after disease progression on treatment with a fluoropyrimidine, oxaliplatin, and irinotecan.

The accelerated approval and priority review status for the programmed cell death 1 receptor inhibitor was given for adult and pediatric patients who have progressed on prior therapy, including fluoropyrimidine, oxaliplatin and irinotecan for those with colorectal cancer, and have no satisfactory alternative options.

In the current study, they tested its safety and tolerability in combination with modified FOLFIRINOX (oxaliplatin 65 mg/m 2 , leucovorin 400 mg/m 2 , irinotecan 140 mg/m 2 , and fluorouracil 400 mg/m 2 bolus followed by 2400 mg/m 2 over 46 hours) in 20 adults with newly diagnosed metastatic pancreatic adenocarcinoma.

The team recruited trial participants with advanced CRC refractory to oxaliplatin and irinotecan, an ECOG performance score of 1 or 2, systemic inflammation, weight loss and other markers of poor prognosis.