Small-cell lung cancer: current therapy and novel agents.
Among patients with lung cancer, approximately 15% have small-cell lung cancer (SCLC). Although, without therapy, untreated SCLC is a rapidly proliferating tumor with a poor prognosis, response rates to chemotherapy and radiotherapy are high. SCLC is usually staged as either limited disease or extensive disease. Extensive disease is treated primarily with chemotherapy. A recent Japanese randomized trial compared IP (irinotecan [Camptosar]/cisplatin [Platinol]) with EP (etoposide/cisplatin). Patients in the IP arm had significantly better outcomes than patients in the EP arm. In the IP arm, the response rate was 84%, and the median overall survival period was 12.8 months. Limited disease is usually treated with concurrent chemotherapy and accelerated radiation therapy, and approximately 20% of patients are cured. Further investigations to improve local control and inhibit distant metastasis are clearly warranted. The dose-rate escalation in radiotherapy (administered concurrently with chemotherapy) is important in improving local control, and the introduction of molecular-targeting agents is necessary to inhibit distant metastasis.
Horiike
Atsushi
A
Division of Internal Medicine, National Cancer Center Hospital, Japan.
Saijo
Nagahiro
N
D000328:Adult; D000367:Age Factors; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis
D018943:Anthracyclines; D005047:Etoposide; D000077146:Irinotecan; C055866:amrubicin; D002945:Cisplatin; D002166:Camptothecin