Small Cell Lung Cancer Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (04/20/2018)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Extensive-Stage Small Cell Lung Cancer (SCLC) Treatment

Revised text in the treatment options under clinical evaluation for patients with extensive-stage SCLC disease to state that new drug regimens include immune checkpoint modulation agents.

Recurrent SCLC Treatment

Revised text of standard treatment options for patients with recurrent SCLC to include immune checkpoint modulation.

Added text to state that for patients with recurrent SCLC, immune checkpoint modulation with anti–programmed death-ligand 1 antibodies may lead to durable responses either as single agents or in combination with anti–cytotoxic T lymphocyte antigen-4. Also added that impacts on long-term survival from these approaches are being assessed in randomized trials.

Revised text to state that response rates for combination agents are generally higher than those reported for single agents, and one phase III study has reported improved survival for patients with sensitive disease who are treated with combination cisplatin, etoposide, and irinotecan; however, higher rates of toxicity have been seen (cited Goto et al. as reference 14).

Added text to state that in a phase III trial conducted in Japan, 180 patients with extensive-stage SCLC, who had responded to first-line platinum-doublet chemotherapy but had their disease progress more than 90 days after completion of chemotherapy, were randomly assigned 1:1 to intravenous topotecan for four cycles or to five 2-week cycles of cisplatin, etoposide, and irinotecan. Added statistical data about the primary endpoint of overall survival, which was significantly prolonged with the combination of cisplatin, etoposide, and irinotecan compared with topotecan alone. Also added that rates of grade 3 to 4 toxicities were higher in patients treated with the combination regimen, and the toxicities included febrile neutropenia and thrombocytopenia (added level of evidence 1iiA).

Added Immune checkpoint modulation as a new subsection.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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