Current Management and New Leads in Small Cell Lung Cancer

Abstract

The introduction of the cisplatin/etoposide combination chemotherapy in the early 1980’s, was the last important improvement in the therapy for patients with small cell lung cancer. Since then further progress in the treatment of small cell lung cancer has been minimal. The outcome of treatment is highly dependent on initial disease stage and performance status. Median survival durations are usually 7 to 10 months in patients with extensive stage disease, and 15 to 20 months in patients with limited stage disease [1–3]. Patients with poor performance status and/or advanced age do worse. Combination chemotherapy is the cornerstone of therapy. In patients with limited stage disease concurrent thoracic radiation therapy produces a modest survival advantage [4]. Although platinum plus etoposide is now generally accepted as superior chemotherapy, the literature has no citations of large direct randomized comparisons versus other regimens. The relative effectiveness, ease of administration, and lack of common severe toxicity, particularly to heart and lungs, when used concurrently with radiotherapy, explains in part the popularity of the platinum plus etoposide regimen.