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Traitement des cancers bronchiques à petites cellules métastatiques en 2012

Treatment of metastatic small-cell lung cancer in 2012

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Oncologie

Abstract

Systemic chemotherapy plays a major role in the management of patients with Stage IV small-cell lung cancer(SCLC). Despite strong initial chemosensitivity, majority of patients relapse within a few months and few patients survive more than a year. Spontaneous prognosis is wrong for at least six weeks. Little progress in the management of this cancer is emerging after many years without real success since the demonstration of efficacy of first-line of cisplatinetoposide combination thirty years ago and the efficacy topotecan as secondline treatment in 2006. Prophylactic cranial irradiation prolongs overall survival in patients who had a response to chemotherapy. Better knowledge in understanding the biology of SCLC has led to the identification of essential signaling pathways but even the prospect of new therapeutic approaches is littered with failures and disappointments. New targets continue to be identified and treatments are currently being evaluated. The inclusion of patients in clinical trials is necessary to improve the survival of patients with SCLC.

Résumé

La chimiothérapie systémique joue un rôle majeur dans la gestion des patients atteints de cancer bronchique à petites cellules (CBPC) de stade IV. Malgré une forte chimiosensibilité initiale, la majorité des patients présentent une récidive en quelques mois et peu de patients survivent plus d’un an. Le pronostic spontané est sombre de l’ordrede six semaines. Depuis la démonstration de l’efficacité en première ligne de l’association cisplatine-étoposide il y a trente ans et du topotécan en deuxième ligne en 2006, peu de progrès dans la prise en charge de ce cancer émergent. L’irradiation prophylactique cérébrale a montré une amélioration de la survie globale chez les patients répondeurs à une première ligne de chimiothérapie. Une meilleure connaissance dans la compréhension de la biologie du CBPC a conduit à l’identification de voies de signalisations essentielles, mais là encore la perspective de nouvelles approches thérapeutiques a été parsemée d’échecs et de désillusions. De nouvelles cibles continuent à être identifiées et des traitements sont actuellement en cours d’évaluation. L’inclusion des patients dans les essais cliniques est primordiale pour espérer améliorer la survie des patients atteints d’un CBPC disséminé.

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  1. Département de pneumologie, CHU d’Angers, 4, rue Larrey, F-49933, Angers cedex 09, France

    N. Baize

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Baize, N. Traitement des cancers bronchiques à petites cellules métastatiques en 2012. Oncologie 14, 320–325 (2012). https://doi.org/10.1007/s10269-012-2160-y

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  • DOI: https://doi.org/10.1007/s10269-012-2160-y

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