title: Small-Cell Lung Cancer: Clinical Management and Unmet Needs New Perspectives for an Old Problem.
abstract: Small cell lung cancer is a highly aggressive, difficult to treat neoplasm. Among all lung tumors, small cell lung cancers account for about 20%. Patients typically include heavy smokers in 70s age group, presenting with symptoms such as intrathoracic tumors growth, distant spread or paraneoplastic syndromes at the time of diagnosis. A useful and functional classification divides small cell lung cancers into limited disease and extensive disease. Concurrent chemo-radiotherapy is the standard treatment for limited disease, with improved survival when combined with prophylactic cranial irradiation. Platinum compounds (cisplatin/carboplatin) plus etoposide remain the cornerstone for extensive disease. Nevertheless, despite high chemo- and radio-sensitivity of this cancer, nearly all patients relapse within the first two years and the prognosis is extremely poor. A deeper understanding about small cell lung cancer carcinogenesis led to develop and test a considerable number of new and targeted agents but the results are currently weak or insufficient. To date, small cell lung cancer is still a challenge for researchers. In this review, key aspects of small cell lung cancer management and controversial points of standard and new treatments will be discussed.
authors.affiliation: Fondazione IRCCS, Istituto Nazionale dei Tumori, Department of Medical Oncology, Thoracic Unit, Via Giacomo Venezian, 1 Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Russo
authors.forename: Marianna
authors.initials: M
authors.lastname: Macerelli
authors.forename: Marco
authors.initials: M
authors.lastname: Platania
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Zilembo
authors.forename: Milena
authors.initials: M
authors.lastname: Vitali
authors.forename: Diego
authors.initials: D
authors.lastname: Signorelli
authors.forename: Claudia
authors.initials: C
authors.lastname: Proto
authors.forename: Monica
authors.initials: M
authors.lastname: Ganzinelli
authors.forename: Rosaria
authors.initials: R
authors.lastname: Gallucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Agustoni
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Fasola
authors.forename: Filippo
authors.initials: F
authors.lastname: de Braud
authors.forename: Marina Chiara
authors.initials: MC
authors.lastname: Garassino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D019468:Disease Management; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D012008:Recurrence; D055752:Small Cell Lung Carcinoma / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Chemotherapy; immunotherapy; management; radiotherapy; small cell lung cancer; target therapies.