Current Diagnosis and Management of Small-Cell Lung Cancer

Shuhang Wang, Stefan Zimmermann, Kaushal Parikh, Aaron Mansfield, Alex Adjei

Research output: Contribution to journalReview article

Abstract

Small-cell lung cancer (SCLC) is an aggressive disease with distinct pathological, clinical, and molecular characteristics from non–small-cell lung cancer. SCLC has high metastatic potential, resulting in a clinically poor prognosis. Early concurrent chemo-radiation is the standard of care for limited-stage SCLC (LS-SCLC). Prophylactic cranial irradiation (PCI) is recommended for patients with LS-SCLC without progression of disease after initial therapy. A combination of etoposide and cisplatin or carboplatin remains the mainstay of first-line treatment for ES-SCLC, with the addition of atezolizumab, now becoming standard. Most SCLCs initially respond to therapy but almost invariably recur. Topotecan and amrubicin (in Japan) remain the primary chemotherapy options for relapsed SCLC. Immunotherapy, including nivolumab with or without ipilimumab, is now available for refractory disease. In general, the poor prognosis of SCLC has not improved significantly for more than 3 decades. Recently, next-generation molecular profiling studies have identified new therapeutic targets for SCLC. A variety of proapoptotic agents, compounds capitalizing on DNA-repair defects, immunotherapy agents, and antibody–drug conjugates are being evaluated in SCLC, with a number of them showing early promise.

Original languageEnglish (US)
Pages (from-to)1599-1622
Number of pages24
JournalMayo Clinic proceedings
Volume94
Issue number8
DOIs
StatePublished - Aug 1 2019

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Small Cell Lung Carcinoma
Immunotherapy
Cranial Irradiation
Topotecan
Carboplatin
Etoposide
Therapeutics
Standard of Care
Non-Small Cell Lung Carcinoma
DNA Repair
Cisplatin
Disease Progression
Japan
Radiation
Drug Therapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Current Diagnosis and Management of Small-Cell Lung Cancer. / Wang, Shuhang; Zimmermann, Stefan; Parikh, Kaushal; Mansfield, Aaron; Adjei, Alex.

In: Mayo Clinic proceedings, Vol. 94, No. 8, 01.08.2019, p. 1599-1622.

Research output: Contribution to journalReview article

Wang, Shuhang ; Zimmermann, Stefan ; Parikh, Kaushal ; Mansfield, Aaron ; Adjei, Alex. / Current Diagnosis and Management of Small-Cell Lung Cancer. In: Mayo Clinic proceedings. 2019 ; Vol. 94, No. 8. pp. 1599-1622.
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