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Management of Extensive Small-Cell Lung Cancer

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Tumors of the Chest

30.10 Conclusion

The treatment of patients with extensive SCLC still remains palliative. In this setting, it is highly important to include patients in clinical trials that evaluate new drugs. For patients who can not be included in trials, the treatment should be tailored according to performance status and patients’ wishes. Three options can be discussed: a four-drug combination when performance status is unaltered, a standard etoposide/cisplatin regimen when there is a minimal alteration of performance status, and when the patient asks for a good quality of life. The combination of carboplatin and etoposide should be given only to patients who present an important performance status alteration or a contraindication to a standard chemotherapy.

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References

  1. Stahel RA, Ginsberg R, Havemann K. Staging and prognostic features in small cell lung cancer: a consensus report. Lung Cancer 1989;59:119.

    Article  Google Scholar 

  2. Fukuoka M, Furuse K, Saijo N, et al. Randomized trial of cyclophosphamide, doxorubicin, and vincristine versus cisplatin and etoposide versus alternation of these regimens in small-cell lung cancer. J Natl Cancer Inst 1991;83:855.

    PubMed  CAS  Google Scholar 

  3. Roth BJ, Johnson DH, Einhorn LH, et al. Randomized study of cyclophosphamide, doxorubicin, and vincristine versus etoposide and cisplatin versus alternation of these two regimens in extensive small-cell lung cancer: a phase III trial of the Southeastern Cancer Study Group. J Clin Oncol 1992;10:282.

    PubMed  CAS  Google Scholar 

  4. Evans WK, Osoba D, Feld R, et al. Etoposide and cisplatin: an effective treatment for relapse in small-cell lung cancer. J Clin Oncol 1985;3:65.

    PubMed  CAS  Google Scholar 

  5. Pujol JL, Carestia L, Daures JP, et al. Is there a case for cisplatin in the treatment of small-cell lung cancer? A meta-analysis of randomized trials of a cisplatin-containing regimen versus a regimen without this alkylating agent. Br J Cancer 2000;83:8.

    Article  PubMed  CAS  Google Scholar 

  6. Skarlos DV, Samantas E, Kosmidis P, et al. Randomized comparison of etoposide-cisplatin vs etoposide-carboplatin and irradiation in small-cell lung cancer. A Hellenic Cooperative Oncology Group study. Ann Oncol 1994;5:601.

    PubMed  CAS  Google Scholar 

  7. Pujol JL, Daures JP, Riviere A, et al. Etoposide plus cisplatin with or without the combination of 4-epidoxorubicin plus cyclophosphamide in treatment of extensive small-cell lung cancer: a French Federation of Cancer Institutes multicenter phase III randomized study. J Natl Cancer Inst 2001;93:300.

    Article  PubMed  CAS  Google Scholar 

  8. Pujol JL, Douillard JY, Riviere A, et al. Dose-intensity of a four-drug chemotherapy regimen with or without recombinant human granulocyte-macrophage colony-stimulating factor in extensive-stage small-cell lung cancer: a multi-center randomized phase III study. J Clin Oncol 1997;15:2082.

    PubMed  CAS  Google Scholar 

  9. Steward WP, von Pawel J, Gatzemeier U, et al. Effects of granulocyte-macrophage colony-stimulating factor and dose intensification of V-ICE chemotherapy in small-cell lung cancer: a prospective randomized study of 300 patients. J Clin Oncol 1998;16:642.

    PubMed  CAS  Google Scholar 

  10. Thatcher N, Girling DJ, Hopwood P, et al. Improving survival without reducing quality of life in small-cell lung cancer patients by increasing the dose-intensity of chemotherapy with granulocyte colony-stimulating factor support: results of a British Medical Research Council Multicenter Randomized Trial. Medical Research Council Lung Cancer Working Party. J Clin Oncol 2000;18:395.

    PubMed  CAS  Google Scholar 

  11. Ardizzoni A, Tjan-Heijnen VC, Postmus PE, et al. European Organization for Research and Treatment of Cancer-Lung Cancer Group. Standard versus intensified chemotherapy with granulocyte colony-stimulating factor support in small-cell lung cancer: a prospective European Organization for Research and Treatment of Cancer-Lung Cancer Group phase III trial-08923. J Clin Oncol 2002;20:3947.

    Article  PubMed  CAS  Google Scholar 

  12. Sculier JP, Paesmans M, Lecomte J, et al. A three-arm phase III randomised trial assessing, in patients with ex tensive-disease small-cell lung cancer, accelerated chemotherapy with support of haematological growth factor or oral antibiotics. Br J Cancer 2001;85:1444.

    Article  PubMed  CAS  Google Scholar 

  13. Murray N, Livingston RB, Shepherd FA, et al. Randomized study of CODE versus alternating CAV/EP for extensive-stage small-cell lung cancer: an intergroup study of the National Cancer Institute of Canada Clinical Trials Group and the Southwest Oncology Group. J Clin Oncol 1999;17:2300.

    PubMed  CAS  Google Scholar 

  14. Furuse K, Fukuoka M, Nishiwaki Y, et al. Phase III study of intensive weekly chemotherapy with recombinant human granulocyte colony-stimulating factor versus standard chemotherapy in extensive-disease small-cell lung cancer. The Japan Clinical Oncology Group. J Clin Oncol 1998;16:2126.

    PubMed  CAS  Google Scholar 

  15. Noda K, Nishiwaki Y, Kawahara M, et al. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. N Engl J Med 2002;346:85.

    Article  PubMed  CAS  Google Scholar 

  16. Schiller JH, Adak S, Cella D, et al. Topotecan versus observation after cisplatin plus etoposide in extensive-stage small-cell lung cancer: E7593 — a phase III trial of the Eastern Cooperative Oncology Group. J Clin Oncol 2001;19:2114.

    PubMed  CAS  Google Scholar 

  17. Von Pawel J, Schiller JH, Shepherd FA, et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol 1999;17:658.

    Google Scholar 

  18. Ardizzoni A. Topotecan in the treatment of recurrent small cell lung cancer: an update Oncologist 2004;9:4.

    Article  PubMed  CAS  Google Scholar 

  19. Von Pawel J, Gatzemeier U, Pujol JL, et al. Phase II comparator study of oral versus intravenous topotecan in patients with chemosensitive small-cell lung cancer. J Clin Oncol 2001;19:1743.

    Google Scholar 

  20. Glisson BS, Kurie JM, Perez-Soler R, et al. Cisplatin, etoposide and paclitaxel in the treatment of patients with extensive small-cell lung carcinoma. J Clin Oncol 1999;17:2309.

    PubMed  CAS  Google Scholar 

  21. Hainsworth J, Gray J, Stroup S, et al. Paclitaxel, carboplatin, and extended schedule etoposide in the treatment of small cell lung cancer: comparison of sequential phase II trials using different dose-intensities. J Clin Oncol 1997;15:3464.

    PubMed  CAS  Google Scholar 

  22. Reck M, von Pawel J, Macha HN, et al. Randomized phase III trial of paclitaxel, etoposide, and carboplatin versus carboplatin, etoposide, and vincristine in patients with small-cell lung cancer. J Natl Cancer Inst 2003;95:1118.

    Article  PubMed  CAS  Google Scholar 

  23. Niell HB, Herndon JE, Miller AA, et al. Randomized phase III intergroup trial of etoposide and cisplatin with or without paclitaxel and GCSF in patients with extensive stage small cell lung cancer. Proc Am Soc Clin Oncol 2002;21:1169.

    Google Scholar 

  24. Mavroudis D, Papadakis E, Veslemes M, et al. Lung Cancer Cooperative Group. A multicenter randomized clinical trial comparing paclitaxel-cisplatin-etoposide versus cisplatin-etoposide as first-line treatment in patients with small-cell lung cancer. Ann Oncol 2001;12:463.

    Article  PubMed  CAS  Google Scholar 

  25. Masters GA, Declerck L, Blanke C, et al. Eastern Cooperative Oncology Group. Phase II trial of gemcitabine in refractory or relapsed small-cell lung cancer: Eastern Cooperative Oncology Group trial 1597. J Clin Oncol 2003;21:1550.

    Article  PubMed  CAS  Google Scholar 

  26. James LE, Rudd R, Gower NH, et al. A phase III ran domized comparison of gemcitabine/carboplatin with cisplatin/etoposide in patients with poor prognosis small cell lung cancer. Proc ASCO 2002;21:A1170.

    Google Scholar 

  27. Auperin A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med 1999;341:476.

    Article  PubMed  CAS  Google Scholar 

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Deberne, M., Andre, F., Besse, B., Soria, JC., Le Chevalier, T. (2006). Management of Extensive Small-Cell Lung Cancer. In: Syrigos, K.N., Nutting, C.M., Roussos, C. (eds) Tumors of the Chest. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-31040-1_30

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  • DOI: https://doi.org/10.1007/3-540-31040-1_30

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