Palliative Radiotherapy With Lurbinectedin in Patients With Extensive Stage Small Cell Lung Cancer

PRIMARY OBJECTIVE: I. To describe the safety in terms of palliative radiation therapy (RT) in combination with uninterrupted lurbinectedin in patients with extensive stage-lung small cell carcinoma (ES-SCLC). SECONDARY OBJECTIVES: I. To determine the feasibility of delivering palliative RT in combination with lurbinectedin. II. To evaluate the preliminary efficacy of RT plus (+) lurbinectedin, as assessed by: IIa. Radiographic response rates. IIb. Pain response rates. IIc. Progression free survival (PFS). IId. Overall survival (OS). III. To assess patient-reported toxicities to palliative RT + lurbinectedin. EXPLORATORY OBJECTIVE: I. To explore the dose-volume relationships between irradiated bone marrow and hematologic toxicity. OUTLINE: Patients undergo palliative RT over 5 or 10 treatment fractions at the discretion of the treating physician daily for 21 days. Patients also receive lurbinectedin intravenously (IV) over 1 hour on day 1 of each cycle. Cycles of lurbinectedin repeat every 21 days in the absence of disease progression or unacceptable toxicity. After completion of palliative RT, patients are followed up at 1, 3, 6, and 12 months.