Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Oncohealth Institute, Av. de Los Reyes Católicos, 2, 28040, Madrid, Spain.
Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Department of Medicine, Universitat Autònoma de Barcelona. Badalona-Applied Research Group in Oncology (B-ARGO), Fundació Institut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.
Clin Transl Oncol. 2020 Feb;22(2):245-255. doi: 10.1007/s12094-020-02295-w. Epub 2020 Feb 10.
Small-cell lung cancer (SCLC) accounts for 15% of lung cancers. Only one-third of patients are diagnosed at limited stage. The median survival remains to be around 15-20 months without significative changes in the strategies of treatment for many years. In stage I and IIA, the standard treatment is the surgery followed by adjuvant therapy with platinum-etoposide. In stage IIB-IIIC, the recommended treatment is early concurrent chemotherapy with platinum-etoposide plus thoracic radiotherapy followed by prophylactic cranial irradiation in patients without progression. However, in the extensive stage, significant advances have been observed adding immunotherapy to platinum-etoposide chemotherapy to obtain a significant increase in overall survival, constituting the new recommended standard of care. In the second-line treatment, topotecan remains as the standard treatment. Reinduction with platinum-etoposide is the recommended regimen in patients with sensitive relapse (≥ 3 months) and new drugs such as lurbinectedin and immunotherapy are new treatment options. New biomarkers and new clinical trials designed according to the new classification of SCLC subtypes defined by distinct gene expression profiles are necessary.
小细胞肺癌（SCLC）占肺癌的 15%。只有三分之一的患者被诊断为局限期。在多年来治疗策略没有明显变化的情况下，中位生存期仍保持在 15-20 个月左右。在 I 期和 IIA 期，标准治疗是手术，然后用铂类依托泊苷进行辅助治疗。在 IIB 期至 III 期，推荐的治疗方法是早期同时进行铂类依托泊苷联合胸部放疗，然后对无进展的患者进行预防性颅脑照射。然而，在广泛期，将免疫疗法加入到铂类依托泊苷化疗中，观察到显著的进展，从而获得总生存期的显著提高，这构成了新的推荐护理标准。在二线治疗中，拓扑替康仍然是标准治疗药物。对于敏感复发（≥3 个月）的患者，建议使用铂类依托泊苷进行再诱导，新型药物如洛布内替丁和免疫疗法是新的治疗选择。根据 SCLC 亚型的不同基因表达谱定义的新分类，需要新的生物标志物和新的临床试验。
