Cooperative group research endeavors in small-cell lung cancer: current and future directions

The International Lung Cancer Congress (ILCC), now in its ninth year, is a key forum for representatives of cooperative groups in North America, Europe, and Japan to discuss ongoing and planned clinical trials in lung cancer. Many of the significant strides in lung cancer treatment often originate from investigations designed within the cooperative group system and were a feature of the 2008 ILCC. Small-cell lung cancer (SCLC) represents 15% of all lung cancers diagnosed annually and is characterized by rapid growth kinetics, disseminated metastases, and development of chemotherapy resistance. Many questions remain regarding the optimal use of radiation therapy and approaches for enhancing the effects of chemotherapy to improve clinical outcomes. Herein, we explore and outline the scientific vision of each cooperative group's SCLC research portfolio, as presented at the 2008 ILCC. Highlights include an ongoing Intergroup phase III study exploring differing radiation therapy schemes for limited-stage SCLC and a Southwest Oncology Group 0124 trial establishing platinum/etoposide as the standard of care for untreated extensive-stage SCLC in North America. Continued research efforts sponsored by these groups will represent the future of SCLC diagnosis and management.