Limited Stage Small Cell Lung Cancer: Current Treatment and Clinical Trials

Progress in the treatment of patients with small cell lung cancer (SCLC), which seemed so rapid a decade ago, appears to have slowed. This has led to frustration and discouragement. Some of this pessimism is based on premature optimism in the past, but much stems from the realization that over 90% of patients with limited stage SCLC still die of the disease. Such aggregate judgments obscure the facts that major advances have been made in understanding the biologic basis of this disease and that modest but clinically valuable progress has been made in therapy. In view of the large number of patients diagnosed with SCLC each year, relatively small improvement in long-term outcomes can result in the survival of many patients each year. This article reviews the current status of care for patients with limited stage SCLC and discusses directions for clinical research in the 1990s.