Treatment of Small-Cell Lung Cancer: American Society of Clinical Oncology Endorsement of the American College of Chest Physicians Guideline.
OBJECTIVE
The American College of Chest Physicians (ACCP) produced an evidence-based guideline on treatment of patients with small-cell lung cancer (SCLC). Because of the relevance of this guideline to American Society of Clinical Oncology (ASCO) membership, ASCO reviewed the guideline, applying a set of procedures and policies used to critically examine guidelines developed by other organizations.


METHODS
The ACCP guideline on the treatment of SCLC was reviewed for developmental rigor by methodologists. An ASCO Endorsement Panel updated the literature search, reviewed the content, and considered additional recommendations.


RESULTS
The ASCO Endorsement Panel determined that the recommendations from the ACCP guideline, published in 2013, are clear, thorough, and based on current scientific evidence. ASCO endorses the ACCP guideline on the treatment of SCLC, with the addition of qualifying statements.


CONCLUSIONS
Surgery is indicated for selected stage I SCLC. Limited-stage disease should be treated with concurrent chemoradiotherapy in patients with good performance status. Thoracic radiotherapy should be administered early in the course of treatment, preferably beginning with cycle one or two of chemotherapy. Chemotherapy should consist of four cycles of a platinum agent and etoposide. Extensive-stage disease should be treated primarily with chemotherapy consisting of a platinum agent plus etoposide or irinotecan. Prophylactic cranial irradiation prolongs survival in patients with limited-stage disease who achieve a complete or partial response to initial therapy and may do so in similarly responding patients with extensive-stage disease as well. Additional information is available at http://www.asco.org/endorsements/sclc and http://www.asco.org/guidelineswiki.
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Charles M
CM
Rudin
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Nofisat
N
Ismaila
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Christine L
CL
Hann
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Narinder
N
Malhotra
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Benjamin
B
Movsas
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Kim
K
Norris
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
M Catherine
MC
Pietanza
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Suresh S
SS
Ramalingam
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Andrew T
AT
Turrisi
Charles M. Rudin and M. Catherine Pietanza, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Christine L. Hann, Johns Hopkins University, Baltimore, MD; Narinder Malhotra, Correct Care Solutions, Pittsburgh; Andrew T. Turrisi III, DeltaMedix, Scranton, PA; Benjamin Movsas, Henry Ford Hospital, Detroit, MI; Kim Norris, Lung Cancer Foundation of America, Los Angeles, CA; Suresh S. Ramalingam, Emory University, Atlanta, GA; and Giuseppe Giaccone, Georgetown University, Washington, DC.
Giuseppe
G
Giaccone
D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008495:Medical Oncology; D017410:Practice Guidelines as Topic; D011379:Prognosis; D055752:Small Cell Lung Carcinoma / Q000628:therapy*