Kalemkerian Gregory P
University of Michigan - Hematology/Oncology , C350 Med Inn - SPC 5848 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5848 , USA
Expert Opin Pharmacother. 2014 Nov;15(16):2385-96. doi: 10.1517/14656566.2014.957180. Epub 2014 Sep 26.
Small cell lung cancer (SCLC) is an aggressive malignancy characterized by early metastatic dissemination and responsiveness to initial therapy. The incidence of SCLC has been declining over the past two decades. Limited-stage SCLC is a potentially curable disease with long-term survival of ∼ 20% when treated with platinum-based chemotherapy plus concurrent thoracic radiation and prophylactic cranial irradiation. For patients with extensive-stage SCLC, survival can be increased with combination platinum-based chemotherapy, but the disease remains incurable.
This review looks at the current advances in pharmacotherapy for SCLC.
Many chemotherapeutic strategies and newer cytotoxic agents have been evaluated in SCLC, and some had promising activity in early clinical trials. However, none have demonstrated consistent improvements in outcome over standard platinum-based treatment. Similarly, although many potential molecular targets have been identified in preclinical studies of SCLC, molecularly targeted therapy has yet to demonstrate any substantial activity in clinical trials. Nonetheless, future advances in this disease will undoubtedly depend on improvements in our understanding of the molecular mechanisms that drive the proliferation and survival of SCLC cells.
小细胞肺癌（SCLC）是一种侵袭性恶性肿瘤，其特征为早期发生转移扩散且对初始治疗有反应。在过去二十年中，SCLC的发病率一直在下降。局限期SCLC是一种潜在可治愈的疾病，采用铂类化疗联合同期胸部放疗及预防性颅脑照射时，长期生存率约为20%。对于广泛期SCLC患者，铂类联合化疗可提高生存率，但该疾病仍无法治愈。
本综述探讨了SCLC药物治疗的当前进展。
许多化疗策略和新型细胞毒性药物已在SCLC中进行了评估，其中一些在早期临床试验中显示出有前景的活性。然而，与标准铂类治疗相比，尚无一种策略能持续改善治疗结果。同样，尽管在SCLC的临床前研究中已确定了许多潜在的分子靶点，但分子靶向治疗在临床试验中尚未显示出任何显著活性。尽管如此，该疾病未来的进展无疑将取决于我们对驱动SCLC细胞增殖和存活的分子机制的理解的改善。
