New perspectives in the management of small cell lung cancer

Abstract

The treatment of small cell lung cancer (SCLC) is a challenge for all specialists involved. New treatments have been added to the therapeutic armamentarium in recent months, but efforts must continue to improve both survival and quality of life. Advances in surgery and radiotherapy have resulted in prolonged survival times and fewer complications, while more careful patient selection has led to increased staging accuracy. Developments in the field of systemic therapy have resulted in changes to clinical guidelines and the management of patients with advanced disease, mainly with the introduction of immunotherapy. In this article, we describe recent improvements in the management of patients with SCLC, review current treatments, and discuss future lines of research.

Magnetic resonance imaging characteristics of brain metastases in small cell lung cancer

“…BMs of SCLC are typically treated with chemotherapy or radiotherapy. In NSCLC, early‐stage BMs can be treated with surgery; chemotherapy is the best option for patients in whom the opportunity for surgery is missed 12,13 . Moreover, the distinction of BMs can assist physicians regarding the treatment of patients presenting with neurological symptoms at their first admission to hospital.…”

“…In NSCLC, early-stage BMs can be treated with surgery; chemotherapy is the best option for patients in whom the opportunity for surgery is missed. 12,13 Moreover, the distinction of BMs can assist physicians regarding the treatment of patients presenting with neurological symptoms at their first admission to hospital. Despite their high sensitivity to radiation therapy, BMs in SCLC are linked to a poor prognosis.…”

New potential targeted strategies in small cell lung cancer

“…Due to the high mutation rate and the finding of an increased expression of PARP1/checkpoint kinase 1 (CHK1), PARP inhibitors (PARPi) have been widely studied for this purpose. They have shown significant growth inhibition of SCLC in vitro and in vivo studies ( 9 ). Also, clinical trials showed a modest benefit when treating with PARPi, as monotherapy or combined with chemotherapy.…”

“…Also, clinical trials showed a modest benefit when treating with PARPi, as monotherapy or combined with chemotherapy. In an early phase clinical trial, talazoparib showed an objective response rate (ORR) of 8.7% ( 9 ). No benefit was observed for maintenance treatment with olaparib after first-line chemotherapy with a platine-combination doublet ( 10 ) or for the addition of veliparib to first-line chemotherapy, with no significant differences in terms of progression-free survival (PFS) or overall survival (OS) ( 9 ).…”

“…Regarding combinations of chemotherapy and PARPi in successive treatment lines, discordant results have been reported ( 9 ). Temozolomide plus veliparib showed no benefit in terms of survival ( 9 ).…”