[Small cell lung cancer (CPC). Second line treatment].
BACKGROUND
Despite their initial chemosensitivity 90% of small cell lung cancers (SCLC) need second line treatment on account of failure to respond to initial treatment, progression after a partial response (PR) or relapse after a complete response (CR).


BACKGROUND
The outlook is universally fatal but, with the exception of patients with very poor performance status, second line treatment is indicated because it gives a 70% response rate in patients relapsing after a CR, using the same treatment if the period before relapse is greater than 3 months. The response rate is 20-30% in cases resistant to first line treatment using different drugs such as topotecan, irinotecan, gemcitabine, and lomustine. Thoracic or cranial irradiation is reserved for palliative indications.


CONCLUSIONS
There is current research aimed at improving quality of life, particularly by using oral treatment. A randomised trial is in progress using a combination of lomustine, cyclophosphamide and etoposide that may lead to comfortable and prolonged survival.


CONCLUSIONS
Further collaborative trials are needed to answer this unresolved question.
Lebeau
B
B
Service de Pneumologie, Hôpital St-Antoine, Université Pierre et Marie Curie-Paris VI. bernard.lebeau@sat.ap-hop-paris.fr
D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D019233:Retreatment; D017211:Treatment Failure