Developments in therapy for extensive-disease small cell lung cancer

Developments in the treatment of extensive small cell lung cancer have proven effective in palliative management but have not yielded improvements in the cure rate for this disease. Strategies involving dose escalation of chemotherapy, including de novo and late intensification dose escalation and dose escalation with growth factor support, have had mixed results in this patient population. Alternating chemotherapy, especially with regimens containing etoposide, has achieved better results overall but has not had a significant impact on survival. Current treatment goals should therefore be focused on short-term palliation of symptoms, at least until more effective drugs are developed. Exploration of resistance modulation strategies and biologic approaches, as well as determining the true value of protracted etoposide treatment, may play a role in future treatment endeavors.