Management of small cell lung cancer

Kristen Keon Ciombor, Caio Max S Rocha Lima

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Small cell lung cancer (SCLC) is an aggressive type of lung cancer characterized by rapid growth and early metastasis. It is chemosensitive and radiosensitive, yet decades of research investigating multimodality treatments have failed to control or cure this disease in most patients. First-line treatment of limited-stage disease consists of chemotherapy (often etoposide/cisplatin or etoposide/carboplatin) combined with thoracic radiation therapy (TRT), followed by prophylactic cranial irradiation to decrease brain metastases as a site of disease progression for those who experience complete remission or a very good partial response to multimodality treatment. In a Japanese trial, the combination of irinotecan and cisplatin had initially shown promise in treating patients with extensive-stage SCLC, but a confirmatory trial in the United States did not find a difference in overall survival with irinotecan/cisplatin versus etoposide/cisplatin. Adding a third drug to the etoposide/cisplatin combination, as well as other triplet therapies, has mostly been ineffective in improving outcomes. Variables in chemotherapy administration, including maintenance therapy, alternating non-cross-resistance regimens, and dose intensification, have not been shown to increase survival at large. In terms of radiation therapy, early administration of TRT concurrent with chemotherapy, and hyperfractionation, have been beneficial in treatment of limited-stage disease. In patients who relapse, second-line therapy options consist of reinduction of previous chemotherapy or administration of a single agent. Targeted biological therapies for SCLC are now being investigated, and although a great deal of research remains to be done, these agents and their derivatives may provide the most hope for future treatment of SCLC.

Original languageEnglish
Pages (from-to)59-68
Number of pages10
JournalCurrent Treatment Options in Oncology
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2006

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Small Cell Lung Carcinoma
irinotecan
Cisplatin
Etoposide
Drug Therapy
Radiotherapy
Therapeutics
Thorax
Neoplasm Metastasis
Cranial Irradiation
Biological Therapy
Survival
Carboplatin
Research
Disease Progression
Lung Neoplasms
Recurrence
Brain
Growth
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Management of small cell lung cancer. / Ciombor, Kristen Keon; Lima, Caio Max S Rocha.

In: Current Treatment Options in Oncology, Vol. 7, No. 1, 01.01.2006, p. 59-68.

Research output: Contribution to journalArticle

Ciombor, Kristen Keon ; Lima, Caio Max S Rocha. / Management of small cell lung cancer. In: Current Treatment Options in Oncology. 2006 ; Vol. 7, No. 1. pp. 59-68.
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