Could we expect to improve survival in small cell lung cancer?
Despite the very good response rate of small cell lung cancer (SCLC) to many anti-cancer agents, survival remains disappointing, particularly in extensive-stage (ES) disease. Many potentially beneficial regimens have achieved a median survival of less than 12 months in clinical trials, and so the standard regimen has remained cisplatin plus etoposide. Trials have shown that 3- and 4-drug regimens are no better than 2-drug regimens; alternating agents, dose-dense and high-dose regimens do not improve outcome, and non-platinum-based regimens are not superior to platinum-based regimens. A recent phase II trial demonstrated that pemetrexed/platinum-based doublets are active in ES-SCLC in the first-line setting. In combination with cisplatin or carboplatin, pemetrexed demonstrated a favourable toxicity profile. The ease of administration and convenient schedule of pemetrexed make these regimens attractive. Although further follow-up of patients in this trial is necessary to define response durability and survival, results so far have led to the initiation of phase III trials of pemetrexed-based regimens in ES-SCLC.
Department of Medical Oncology, Hôpital Beaujon, 100 boulevard du Général Leclerc, 92110 Clichy, France.
Ghassan
G
El Maalouf
Jean-Michel
JM
Rodier
Sandrine
S
Faivre
Eric
E
Raymond
D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D005971:Glutamates / Q000627:therapeutic use; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D000068437:Pemetrexed; D015996:Survival Rate
D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine