Here is the last case I discussed several months ago with Dr. Nasser Hanna, lung cancer expert at Indiana University. After two cases that included never or light former smokers, which he joked that I saw far more of than he did, we changed direction to cover current issues in managing extensive stage small cell lung cancer, a field in which he's been a leader.

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Here's the podcast from a webinar I did last month with Dr. Weiss on the subject of whether patients with very limited small cell lung cancer (SCLC) should perhaps undergo surgery as a first intervention. Historically, surgery isn't considered as a typical treatment for patients with SCLC, even if it's very early stage, but some results from retrospective experiences suggest that the patients who undergo surgery in this setting do very well.

The development of targeted therapy drugs has improved survival for patients with NSCLC, and the “pipeline” of agents in development awaiting further testing in clinical trials seems to be increasing by the day. The improvements in survival in particular subpopulations of patients with NSCLC inspires both patients and physicians who treat lung cancer to hope that similar gains may be made, perhaps incrementally, for patients in all subpopulations of NSCLC.

A few weeks ago, I gave a talk at a Seattle non-profit called Cancer Lifeline, at which I described some of the highlights of current lung cancer treatment and the direction of ongoing research. I recorded that lecture (which does include some stray sounds in the background), and I thought it would be helpful to make it available to people online.

I recently had the opportunity to sit down with Dr. Toni Wozniak, Moedical Oncologist and lung cancer expert at the Barbara A. Karmanos Cancer Center at Wayne State University in Detroit, MI. We covered several topics, including SCLC, the subject of this podcast. It is an audio interview but includes a few figures that are synchronized with the audio on the video version, or you can download the pdf of the figures and just follow along with the audio.

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Several years ago, I participated in a clinical trial with a combination of carboplatin and irinotecan for treatment of extensive SCLC, just now being published (abstract here).

We've covered the modest activity of a few mTOR inhibitors in NSCLC (see prior post), so now we'll turn to SCLC.

The treatment of relapsed SCLC isn’t especially controversial, because this is an area where there aren’t enough breakthroughs. In someone fit enough to perform their own activities of daily living and getting out of the house, the main question is how long it has been since they completed their first line treatment.

I go to many meetings in which cases are presented and medical oncologists provide their repsonses about how they'd be inclined to treat a patient. Although we bemoan the lack of much progress in managing small cell lung cancer, one of the effects of that is that there is pretty strong uniformity in how we manage it, since the standards are quite well established.

In my earliest introductory post about SCLC, I described the typical staging breakdown used clinically, which is essentially divided into limited disease SCLC (LD-SCLC), which is typically treated with chemo and chest radiation together, with curative intent, and extensive disease SCLC (ED-SCLC), which is typically treated with chemo alone and is not considered conventionally curable.