Emerging treatments for small-cell lung cancer: Phase II and III trials

Joel W Neal, Matthew A Gubens, Heather A Wakelee

Small-cell lung cancer (SCLC) comprises up to 20% of lung cancers, and continues to have a long-term survival rate in limited disease of only approximately 15%. Advanced stage disease is often fatal in less than 1 year. Over the last 30 years, the treatment for extensive stage SCLC has remained relatively unchanged. Treatment with cisplatin or carboplatin plus etoposide leads to response rates over 70%, but patients inevitably recur with subsequent rapid progression. Newer chemotherapeutics such as irinotecan, amrubicin and picoplatin have shown some promising activity. Inhibitors of angiogenesis, such as bevacizumab and thalidomide, have shown minimal activity to date. Hope lies with ongoing clinical trials with novel targeted agents against various oncogenic signaling pathways in SCLC.