Multimodality Therapy for Limited-Stage Small-Cell Lung Cancer

Almquist, Daniel; Mosalpuria, Kailash; Ganti, Apar Kishor

doi:10.1200/jop.2015.009068

Cited by 18 publications

(21 citation statements)

References 52 publications

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“…2 Response rates approximate 60% to 70% with initial therapy in limited-stage disease (disease for which the treatment standard remains chemotherapy with four to six cycles of cisplatin and etoposide and concurrent radiation therapy, followed by prophylactic cranial irradiation in responders). 2,3 For the 60% to 70% of patients presenting with extensive-stage disease at diagnosis, standard treatment includes four to six cycles of cisplatin or carboplatin and etoposide or irinotecan (clinical trials have not supported the superiority of irinotecan over etoposide in the United States and Europe), followed by consideration for prophylactic cranial irradiation and thoracic radiation therapy in responders. 2,[4][5][6] The median overall survival (OS) approximates 20 months in limited-stage SCLC, with estimated 5-year survival rates of , 15%, whereas the median OS is approximately 8 to 12 months for extensivestage SCLC, with 5-year survival rates of , 2%.…”

Section: Introductionmentioning

confidence: 99%

Managing Patients With Relapsed Small-Cell Lung Cancer

Gong

Salgia

2018

JOP

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Despite high response rates to initial therapy, relapses are common in patients with small-cell lung cancer (SCLC). Systemic therapy after first-line failure remains important in the treatment paradigm of SCLC. Reinitiation of a previously administered first-line chemotherapy regimen is recommended for relapse > 6 months from completion of initial therapy. For relapse ≤ 6 months of initial therapy, sequential therapy with single agents is recommended. Clinical trial enrollment should be considered at all stages of treatment of SCLC. This review highlights the available treatment options in relapsed SCLC. In particular, we focus on prospective clinical trials demonstrating activity for the most commonly used agents in this setting. We end with a discussion on future directions and emerging targets with potential to improve outcomes in relapsed SCLC.

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Section: Introductionmentioning

confidence: 99%

Managing Patients With Relapsed Small-Cell Lung Cancer

Gong

Salgia

2018

JOP

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“…Second, in addition to concurrent chemoradiotherapy, aggressive surgery is beneficial to potentially curable limited-stage SCLC. [ 16 ] Besides, an accurate staging is critical before surgery. Multidisciplinary therapies make more patients eligible for surgical resection.…”

Section: Discussionmentioning

confidence: 99%

A recurrence-free survivor with chemotherapy-refractory small cell lung cancer after pneumonectomy

Pan

Kong

Wang³

et al. 2017

Medicine

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Rationale:The optimal therapeutic regimen for chemotherapy-refractory and node-positive small-cell lung cancer (SCLC) is criticizable for the lack of evidence.Patient concerns:A patient with locally advanced SCLC was insensitive to the first-line chemotherapy of etoposide, irinotecan, and cisplatin.Diagnoses:The patient was diagnosed as SCLC with mediastinal lymph node metastasis by pathological staining.Interventions:Salvage pneumonectomy and systematic lymph node dissection combined with oral apatinib and mediastinal radiotherapy were performed for him.Outcomes:The patient survived for more than 2 years without recurrence after the operation and adjuvant therapy.Lessons:For patients with chemotherapy-resistant but resectable SCLC, a timely resection combined with postoperative radiotherapy and apatinib might be effective.

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“…Currently the National Comprehensive Cancer Network (NCCN) recommends that the primary treatment of medically inoperable T1-T2 N0 patients can include Stereotactic Body Radiation Therapy (SBRT), but data is limited. 10 For operable patients, lobectomy with adjuvant therapy is an option which is primarily based off a National Cancer Database (NCDB) study performed by Yang et al 11 Several institutions have reported their experience with SBRT in early stage SCLC. [12][13][14] SBRT is an advanced method of radiotherapy delivery characterized by high dose per fraction and precise tumor targeting given over a limited number of fractions (typically 5 or less).…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy versus conventional radiotherapy for early-stage small cell lung cancer

et al. 2019

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Purpose: This study was designed to compare survival outcomes for non-surgically managed T1-T2N0M0 small cell lung cancer (SCLC) who received either stereotactic body radiation therapy (SBRT) or conventionally fractionated radiotherapy (CFRT) using the National Cancer Data Base (NCDB). Methods: The was queried between 2004-2015 for patients with T1-T2N0M0 SCLC. Patients must have been treated with curative intent SBRT or CFRT (delivered daily or twice daily, 45-70 Gy) with or without chemotherapy. The primary outcome was overall survival (OS). A subset analysis of patient receiving chemotherapy was also performed. A propensity score matched (PSM) analysis was performed to compare OS among patients who received chemotherapy. Results: We evaluated 1378 patients in the general cohort. Multivariable Cox regression analysis(MVA) in the general cohort revealed that SBRT was significantly associated with improved survival (HR 0.68, p<0.001) along with receipt of chemotherapy (HR 0.63, p <0.001). SBRT patients were less likely to receive chemotherapy compared to CFRT patients (p<0.01). In the chemotherapy subset, of 1096 patients, on MVA, there was a trend in favor of the SBRT group (HR 0.73; p=0.06). A 3:1 PSM analysis on the chemotherapy subset found similar results on MVA with a trend in favor of SBRT (p=0.06). Conclusion: Patients with T1-2N0M0 SCLC treated with SBRT regimens incorporating chemotherapy had comparable outcomes to concurrent chemoradiotherapy using standard fractionation. Treatment paradigms for T1-2N0M0 SCLC incorporating SBRT warrant further exploration and should incorporate chemotherapy.

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Multimodality Therapy for Limited-Stage Small-Cell Lung Cancer

Cited by 18 publications

References 52 publications

Managing Patients With Relapsed Small-Cell Lung Cancer

Managing Patients With Relapsed Small-Cell Lung Cancer

A recurrence-free survivor with chemotherapy-refractory small cell lung cancer after pneumonectomy

Stereotactic body radiotherapy versus conventional radiotherapy for early-stage small cell lung cancer

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