Current Standards for Clinical Management of Small Cell Lung Cancer

Anna F. Farago; Florence K. Keane

Disclosures

Transl Lung Cancer Res. 2018;7(1):69-79. 

In This Article

Abstract and Introduction

Abstract

Small cell lung cancer (SCLC) is an aggressive high-grade neuroendocrine carcinoma. Despite over 30 years of clinical research, little progress has been made in the management of SCLC, and outcomes remain poor. Here, we review the current clinical standards for management of SCLC and the data supporting these strategies.

Introduction

Small cell lung cancer (SCLC) is an aggressive high-grade neuroendocrine malignancy with high metastatic potential and poor clinical outcomes. First characterized as a tumor of lung origin and described as "oat-celled sarcoma" in 1926[1] (though SCLC is in fact a carcinoma), SCLC was recognized early as a cancer that is initially highly sensitive to cytotoxic chemotherapy. Indeed, there was initial hope that, with enough cytotoxic therapy, metastatic SCLC could be curable. However, despite over 30 years of clinical trials designed to improve therapies for SCLC, the vast majority of SCLCs remain incurable. The median overall survival (mOS) for patients with metastatic SCLC receiving standard chemotherapy has remained in range of 9–11 months over the past 20+ years, even in the most recent large randomized clinical trials.[2–6] While there is tremendous hope for therapeutic breakthroughs to come from improved preclinical models, promising new therapeutic strategies, and innovative clinical trials, it is instructive to review the current clinical management strategies for patients diagnosed with SCLC today. Here, we provide an overview of current clinical standards in both medical oncology and radiation oncology, and we review the data supporting those strategies.

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