nsclc vs sclc - 1264506

wjjlyj
Posts:12

My husband was diagnosed with stage 4 lung cancer april 2014. 67 healthy otherwise non-smoker. Original biopsy at local hospital sclc but when sent to Mass General results inconclusive. Went through 3 rounds of cisplatin/etopisode. Main tumor shrunk, but not as much as expected if sclc. Went for second opinion Sylvester Cancer Ctr (U of Miami). Lung specialist suggests 2nd biopsy scheduled for Thursday. Also suggested to hold off on radiation (not yet started) and that we continue with 4th treatment of chemo in the meantime. Is cisplatin/etopisode and radiation beneficial for both nsclc and for sclc? Thank you.

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Reply # - June 21, 2014, 03:03 PM

JimC
Posts: 2753

Although the combination of chemotherapy and radiation is not the normal choice for Stage IV lung cancer (unless there is a tumor which is pressing on a vital structure or threatening a debilitating bone fracture, in which case radiation is added to chemotherapy), there are individual cases which are exceptions. Chemorads are often used in earlier stage lung cancer, and the combination of cisplatin/etoposide is often used, as described in Dr. Pinder's post on stage III lung cancer: http://cancergrace.org/lung/2010/08/22/introduction-to-locally-advanced…

So the answer is yes, this regimen is active against both NSCLC and SCLC.

JimC
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Reply # - June 21, 2014, 06:21 PM

Dr West
Posts: 4735

Jim's exactly right that radiation is generally not pursued for stage IV NSCLC, but for extensive stage SCLC, chest radiation for residual disease will likely be increasingly favored based on the results of a randomized trial by Slotman and colleagues that was just presented at ASCO 2014 and showed a major benefit in not only local disease control and freedom from local recurrence in the chest, but also a significant improvement in survival. We'll be covering this on the GRACE site in a few weeks.

However, cisplatin/etoposide is the preferred regimen for small cell lung cancer (or at least always among the top 2-3) and is also a perfectly good one for NSCLC, so you really can't be far off by using it for any lung cancer, even if there isn't complete certainty about whether it's SCLC or NSCLC.

Good luck.

-Dr. West

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