Small-cell lung cancer

Treatment progress and prospects

Romnee Clark, D. C. Ihde, F. A. Greco, D. Ettinger

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Although small-cell lung cancer (SCLC) represents only 20% of all lung cancer cases in the United States, it is the most lethal subtype. Combination chemotherapy unequivocally offers the best chance for improved survival in SCLC. Either PE (platinum plus etoposide) or CAV (cyclophosphamide, Adriamycin, and vincristine) is a reasonable first-line therapy. Alternating PE with CAV does not appear to be significantly superior to PE or CAV alone. Increasing dose intensity, although sometimes associated with higher response rates, does not appear to significantly improve survival and should not be used outside of a clinical study. Several new agents with novel mechanisms of action show promise in treating SCLC. These include: gemcitabine (Gemzar), paclitaxel (Taxol), docetaxel (Taxotere), topotecan (Hycamtin), and irinotecan (Camptosar). Given the poor survival and response rates in relapsed patients and the chemoresponsiveness of SCLC, patients with newly diagnosed extensive disease should be encouraged to enroll in phase I or II trials. Thoracic radiotherapy confers a small survival advantage in limited- stage SCLC patients. Although prophylactic cranial irradiation does not significantly improve survival, it does reduce central nervous system (CNS) recurrences with minimal long-term sequelae. Surgery should be considered only for: (1) resection of a solitary pulmonary nodule, which must be followed by adjuvant chemotherapy; and (2) resection of an unresponsive chest tumor, which may harbor a non-small-cell lung cancer component.

Original languageEnglish (US)
Pages (from-to)647-663
Number of pages17
JournalOncology (Williston Park, N.Y.)
Volume12
Issue number5
StatePublished - 1998
Externally publishedYes

Fingerprint

Small Cell Lung Carcinoma
irinotecan
docetaxel
gemcitabine
Vincristine
Etoposide
Platinum
Doxorubicin
Cyclophosphamide
Topotecan
Survival
Paclitaxel
Thorax
Solitary Pulmonary Nodule
Cranial Irradiation
Therapeutics
Adjuvant Chemotherapy
Combination Drug Therapy
Non-Small Cell Lung Carcinoma
Lung Neoplasms

ASJC Scopus subject areas

  • Oncology

Cite this

Clark, R., Ihde, D. C., Greco, F. A., & Ettinger, D. (1998). Small-cell lung cancer: Treatment progress and prospects. Oncology (Williston Park, N.Y.), 12(5), 647-663.

Small-cell lung cancer : Treatment progress and prospects. / Clark, Romnee; Ihde, D. C.; Greco, F. A.; Ettinger, D.

In: Oncology (Williston Park, N.Y.), Vol. 12, No. 5, 1998, p. 647-663.

Research output: Contribution to journalArticle

Clark, R, Ihde, DC, Greco, FA & Ettinger, D 1998, 'Small-cell lung cancer: Treatment progress and prospects', Oncology (Williston Park, N.Y.), vol. 12, no. 5, pp. 647-663.
Clark, Romnee ; Ihde, D. C. ; Greco, F. A. ; Ettinger, D. / Small-cell lung cancer : Treatment progress and prospects. In: Oncology (Williston Park, N.Y.). 1998 ; Vol. 12, No. 5. pp. 647-663.
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