Relapsed small-cell lung cancer: a B7-H3 antibody–drug conjugate beat topotecan on survival

The edition in brief

In the phase 3 TAISHAN-302 trial, 451 patients with small-cell lung cancer that had progressed after platinum-based chemotherapy were randomised to tambotatug pelitecan, an antibody–drug conjugate targeting B7-H3, or topotecan. At a prespecified interim analysis, median overall survival was 13.3 versus 9.4 months (HR 0.46, 95% CI 0.35–0.62), progression-free survival 7.4 versus 2.8 months, and response 59.1% versus 9.7%, with fewer grade 3 or higher adverse events (55.4% vs 77.9%). The trial was open-label and the drug is not approved by the FDA, EMA or CDSCO. A meta-analysis of four randomised trials (1,872 patients) found fruquintinib raised grade 3 or higher hypertension ninefold and severe hand-foot skin reaction markedly, with more proteinuria. A Lancet Oncology analysis found cancer-control spending data for only 37% of countries; per-capita spending averaged $3.90 in lower-middle-income countries against $173 in high-income ones. The FDA recorded a supplement to the osimertinib application; its content is not specified.