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Published on: February 12, 2017
Advances in pharmacotherapy of small cell lung cancer
1University of Michigan - Hematology/Oncology , C350 Med Inn - SPC 5848 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5848 , USA kalemker@umich.edu.
Introduction:
Small cell lung cancer (SCLC) is an aggressive malignancy characterized by early metastatic dissemination and responsiveness to initial therapy. The incidence of SCLC has been declining over the past two decades. Limited-stage SCLC is a potentially curable disease with long-term survival of ∼ 20% when treated with platinum-based chemotherapy plus concurrent thoracic radiation and prophylactic cranial irradiation. For patients with extensive-stage SCLC, survival can be increased with combination platinum-based chemotherapy, but the disease remains incurable.
Areas Covered:
This review looks at the current advances in pharmacotherapy for SCLC.
Expert Opinion:
Many chemotherapeutic strategies and newer cytotoxic agents have been evaluated in SCLC, and some had promising activity in early clinical trials. However, none have demonstrated consistent improvements in outcome over standard platinum-based treatment. Similarly, although many potential molecular targets have been identified in preclinical studies of SCLC, molecularly targeted therapy has yet to demonstrate any substantial activity in clinical trials. Nonetheless, future advances in this disease will undoubtedly depend on improvements in our understanding of the molecular mechanisms that drive the proliferation and survival of SCLC cells.
Insights
Despite advances, standard platinum-based chemotherapy remains the primary treatment for small cell lung cancer (SCLC). Future progress in SCLC pharmacotherapy hinges on understanding its molecular drivers.
Area of Science:
- Oncology
- Pharmacotherapy
- Lung Cancer Research
Background:
- Small cell lung cancer (SCLC) is an aggressive malignancy with early metastasis.
- Limited-stage SCLC offers potential cure with platinum-based chemotherapy, radiation, and cranial irradiation.
- Extensive-stage SCLC survival is improved with chemotherapy but remains incurable.
Purpose of the Study:
- To review current advances in pharmacotherapy for SCLC.
- To evaluate the efficacy of novel agents and molecularly targeted therapies.
Main Methods:
- Review of clinical trials and preclinical studies on SCLC pharmacotherapy.
- Analysis of chemotherapeutic strategies and newer cytotoxic agents.
- Examination of molecularly targeted therapy development.
Main Results:
- Numerous chemotherapeutic strategies and cytotoxic agents show promise in early trials but do not consistently improve outcomes over standard platinum-based treatment.
- Molecularly targeted therapies have not yet demonstrated substantial clinical activity despite preclinical identification of potential targets.
Conclusions:
- Standard platinum-based chemotherapy remains the cornerstone of SCLC treatment.
- Future breakthroughs in SCLC treatment depend on a deeper understanding of the molecular mechanisms driving cancer cell proliferation and survival.
- Continued research into molecular targets is crucial for developing effective SCLC therapies.
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