Current status of therapy for small cell carcinoma of the lung

Small cell carcinoma of the lung (SCCL) is distinguished from other types of lung cancer by its propensity for early development of distant metastases and its rapidly fatal clinical course in the absence of treatment. The introduction of chemotherapy into the management of SCCL has led to a four- to five-fold improvement in median survival and to the cure of a small proportion of patients with this disease. Employment of three- or four-drug regimens with or without chest irradiation in moderately intensive doses for periods of 12 months or less has proven to be the optimal therapeutic strategy with currently available agents. Despite these substantial gains, it is obvious that the vast majority of SCCL patients are continuing to die from their cancer, and a slowing in the pace of treatment advances has become apparent over the past 5 years. This article reviews current areas of active clinical investigation in SCCL and some information developed in the cell biology laboratory that may have eventual application in the clinic.