Systemic Therapy for Small-Cell Lung Cancer: ASCO-Ontario Health (Cancer Care Ontario) Guideline

Abstract

PURPOSE To provide evidence-based recommendations to practicing clinicians on the management of patients with small-cell lung cancer. METHODS An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2022. Outcomes of interest included response rates, overall survival, disease-free survival or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 95 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Evidence-based recommendations were developed to address systemic therapy options, timing of therapy, treatment in patients who are older or with poor performance status, role of biomarkers, and use of myeloid-supporting agents in patients with small-cell lung cancer. Additional information is available at www.asco.org/thoracic-cancer-guidelines .

Comparison of Irinotecan/carboplatin versus Etoposide/carboplatin for extended disease small cell lung cancer (ED-SCLC): A systematic review and meta-analysis of randomized controlled trials

“…This result highlights the encouraging survival rates of Chemoimmunotherapy in clinical use. According to ACSO Guidelines 2023, Patients with untreated or previously treated ES-SCLC receiving chemotherapy or chemo-immunotherapy may be administered Trilaciclib or granulocyte colony-stimulating factor (G-CSF) as a myeloid-supportive drug and is recommended to be given to adult patients before receiving a platinum/etoposide-containing regimen or a topotecan-containing treatment for extensive-stage small cell lung cancer in order to reduce the incidence of myelosuppression during chemotherapy [25], [26].…”

The Efficacy and Safety of Anlotinib Plus Etoposide with Cisplatin/Carboplatin in the First-Line Treatment of Lung Cancer: A Phase II Clinical Study

“…Our study takes a novel approach by introducing anlotinib in first-line treatment, providing a potential avenue to enhance outcomes in ES-SCLC patients. This strategy aligns with the evolving landscape of lung cancer treatment, where integrating novel agents with traditional therapies is increasingly recognized as a viable approach to overcoming treatment resistance and improving survival rates [35,36]. While NSCLC has witnessed substantial advancements with targeted therapies and immunotherapies, ES-SCLC has not experienced the same level of therapeutic evolution due to its unique biological characteristics [37,38].…”

Drug Shortages in Oncology: ASCO Clinical Guidance for Alternative Treatments

“…Recommended treatment 51 if the time since last platinum therapy is >90 days (or 180 days, depending on guidelines followed) and the patient is platinum-sensitive:Rechallenge with platinum-based regimenSingle-agent chemotherapy (topotecan or lurbinectedin)…”