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extensive stage small cell lung cancer

Denise Brock

Lung Cancer Video Library – Spanish Language: Video #40 The General Approach to Extensive Stage Small Cell Cancer

GRACE Cancer Video Library - Lung


We are pleased to continue this series of informational videos for our Spanish speaking community.  GRACE is pleased to welcome Dr. Rafael Santana-Davila, Assistant Professor with the University of Washington School of Medicine and Seattle Cancer Care Alliance.  In this 40th video for the Spanish lung cancer video library, Dr. Santana-Davila joined GRACE to discuss the general approach to extensive stage small cell lung cancer.  




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TRANSCRIPTS – Spanish and English
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Los Principios de Tratamiento Cuando el Cáncer de Células Pequeñas está en Estadio Extendido

The General Approach to Extensive Stage Small Cell Cancer


Rafael Santana-Davila, MD
Assistant Professor of Medicine
University of Washington Seattle Cancer Care Alliance
Seattle, Washington



Cuando el cáncer de células pequeñas está en estadio extendido es básicamente cuando el cáncer está en otras partes del pulmón o en otras partes del cuerpo. En este tipo de cáncer, el principio no es curar al paciente si no tratar de extender su vida y mejorar la calidad de ésta. En la mayoría de los casos el principio es quimioterapia, hay varios tipos de ésta que se pueden usar pero dependen de la conversación del doctor con el paciente para que conozca los riesgos, beneficios y los efectos adversos de cada tipo de quimioterapia. Se dan regularmente dos ciclos de quimioterapia y después se vuelven a hacer estudios de imágenes para ver cómo está respondiendo el cáncer. Lo más común es dar cuatro ciclos de quimioterapia y después de esto se puede usar radiación para consolidar las ganancias que obtuvo la quimioterapia.



When small cells lung cancer is in extensive stage is when the cancer cells are in other parts of the lung or even in other parts of the body. In this type of cancer, the goal is not to cure the patient but to try to extend their life and improve their life quality. In most cases the treatment suggested is chemotherapy, which has different types of approaches and they all depend on the conversation the doctor and the patient have in order for the patient to understand the risks, benefits and possible side effects. Regularly, we give two cycles of chemotherapy and then we make again imaging studies to see how the cancer is responding. Four cycles of chemotherapy are the most common treatment to give and then we use radiation to concentrate the good effects chemotherapy had in the cancer cells.

Dr West

Small Cell Lung Cancer Update, from ASCO 2012 Lung Cancer Highlights Program


Here’s the last portion of Dr. Socinski’s presentation, which covers two important trials in small cell lung cancer (SCLC) presented at ASCO 2012.  The first was a SWOG trial of the standard second line agent topotecan (here given on a weekly schedule) either alone or combined with the antiangiogenic agent Eylea (aflibercept).  The results of this trial were generally considered encouraging enough to warrant further study, and you can learn the details from his talk.

He also covers an important study done by the Japanese Cooperative Oncology Group (JCOG), which compared cisplatin/amrubicin to cisplatin/irinotecan, which is standard first line therapy for extensive stage SCLC in Japan.  Dr. Socinski reviews the results and places them in context for us.

Below is the video and audio versions of the podcast, along with the transcript and figures.

Dr. Socinski ASCO LC Highlights 2012 SCLC Update Audio Podcast

Dr. Socinski ASCO LC Highlights 2012 SCLC Update Transcript

Dr. Socinski ASCO LC Highlights 2012 SCLC Update Figs

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Dr West

Amrubicin for SCLC: Recap from ASCO


Though there are many presentations to discuss in the wake of ASCO, we’ll need to pace ourselves on these. I and some of the other faculty members will offer thoughts on some of these in the coming weeks, and we also have our upcoming post-ASCO review on June 23rd (click here to learn more and sign up for this free online program).

Today we saw the results of a couple of long-awaited trials of treatment approaches that represented a couple of the more promising concepts for moving forward in our treatment of extensive SCLC, and I’ll cover the first of these today (though only with the benefit of my notes, rather than as many details as I’d like, so these comments are subject to revision and added details later). Amrubicin has been the subject of some prior discussion here, but that discussion focused on smaller, phase II trials; we’ve needed the results of a randomized phase III trial that directly compares the chemo agent amrubicin as a single agent to our current standard for Hycamtin (topotecan). The ACT-1 trial in enrolled 637 patients with extensive disease SCLC who had all received first line therapy and then relapsed — the trial included patients who had a “sensitive” relapse, 3 or more months after prior chemo had ended, as well as “resistant” relapse, which is marked by progression within 3 months of prior chemo ending (pretty evenly split at nearly 50/50 on the trial). Patients were randomized 2:1 to either amrubicin at 40 mg/m2 IV on days 1-3 of a 21 day cycle, or topotecan at 1.5 mg/m2 IV days 1-5 of a 21 day cycle.

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