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Oral Topotecan FDA Approved in US for Second Line SCLC

December 18, 2007 - 10:24 pm

   This bit of news slipped under the radar for the past six weeks, but oral topotecan was approved by the FDA for the treatment of SCLC that has recurred at least 45 days after the last chemotherapy had been given.  I’m a little embarrassed to say that I hadn’t noted this, but it really […]

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Is More Better in SCLC? Triplets vs. Platinum/Etoposide

November 5, 2007 - 11:12 pm

   We’ve always been tempted to see if we can add more to standard approaches to improve our outcomes. In SCLC, people have attempted to add taxol to cisplatin and etoposide as part of the PET regimen (platinum + etoposide + taxol).  Although heavily tested, it clarified that triplet therapy with standard chemo for SCLC […]

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Treating Elderly and Poorer Performance Status Patients with Small Cell Lung Cancer

August 28, 2007 - 9:18 pm

  The fact is that lung cancer, like many others, is a disease disproportionately affecting older populations, with the median age now in the 69-70 range.
 (Click to enlarge)
But our trials in lung cancer only rarely involve patients over 70.  This leaves us with serious questions about the best way to treat older and poor performance […]

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Prophylactic Cranial Irradiation (PCI) for ED-SCLC

June 19, 2007 - 10:43 pm

  As I described in prior post, prophylactic cranial irradiation (PCI) is established as a treatment approach for patients with LD-SCLC who have had a complete or “good partial” response to chemo and radiation.  Some physicians also recommend PCI for patients with ED-SCLC who have experienced a very good response, since about 10% of the patients on […]

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Treatment of Recurrent SCLC: Evidence for Survival Benefit

January 7, 2007 - 4:31 pm

   As I mentioned in my introduction to the topic, SCLC is typically sensitive to chemo and radiation initially, but it tends to be considerably less responsive after recurrence.  Unfortunately, most SCLC patients, or about 75-80% of patients with LD-SCLC and nearly 100% of patients with ED-SCLC , do subsequently recur.   One key theme is that the longer […]

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Maintenance Chemotherapy for Extensive-Disease Small Cell Lung Cancer (ED-SCLC)?

December 25, 2006 - 10:52 pm

   As I described in a post describing the general principles of SCLC, it is typically responsive to treatment initially, but upon recurrence it is much less likely to respond.  Given that pattern, the value of maintenance therapy has been tested in ED-SCLC, where treatment with initial standard doublet chemo was followed immediately by single-agent […]

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Prophylactic Cranial Irradiation for SCLC

December 2, 2006 - 4:12 pm

   Prophylactic cranial irradiation, or PCI, for SCLC, usually limited disease (LD-SCLC), remains a controversial issue, although this is generally recommended for patients with LD-SCLC who have a complete response to treatment (no evidence of disease).   However, the idea of radiating the brain of someone who has no evidence of cancer there and may never […]

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Old and New Approaches to Initial Treatment of Extensive SCLC

November 26, 2006 - 3:32 pm

   While progress in small cell lung cancer (SCLC) has been slow, over the past few years there have been leads in management of extensive disease that have introduced a potential change in the standard of care based on better results.  Extensive disease SCLC, or ED-SCLC, is defined by having cancer that has spread outside of […]

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Small Cell Lung Cancer 101: An Introduction

November 24, 2006 - 3:25 pm

   After several weeks of posts on other aspects of lung cancer, I am long overdue to write on small cell lung cancer (SCLC).  Although it is good to see the number of SCLC cases decreasing over time, and becoming a smaller and smaller percentage of lung cancer cases overall (only about 13% in the […]

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