City of Hope National Medical Center, Duarte, CA.
J Oncol Pract. 2018 Jun;14(6):359-366. doi: 10.1200/JOP.18.00204.
Despite high response rates to initial therapy, relapses are common in patients with small-cell lung cancer (SCLC). Systemic therapy after first-line failure remains important in the treatment paradigm of SCLC. Reinitiation of a previously administered first-line chemotherapy regimen is recommended for relapse > 6 months from completion of initial therapy. For relapse ≤ 6 months of initial therapy, sequential therapy with single agents is recommended. Clinical trial enrollment should be considered at all stages of treatment of SCLC. This review highlights the available treatment options in relapsed SCLC. In particular, we focus on prospective clinical trials demonstrating activity for the most commonly used agents in this setting. We end with a discussion on future directions and emerging targets with potential to improve outcomes in relapsed SCLC.
尽管初始治疗的反应率很高,但小细胞肺癌(SCLC)患者经常会复发。一线治疗失败后的系统治疗在 SCLC 的治疗模式中仍然很重要。对于初始治疗完成后 6 个月以上复发的患者,建议重新使用之前使用的一线化疗方案。对于初始治疗后 6 个月内复发的患者,建议使用单药序贯治疗。在 SCLC 的治疗的各个阶段都应考虑参加临床试验。本综述强调了复发性 SCLC 的可用治疗选择。特别是,我们专注于展示该治疗环境中最常用药物活性的前瞻性临床试验。最后,我们讨论了未来的方向和新兴的靶点,这些靶点有可能改善复发性 SCLC 的预后。