Yu Ying, Chen Kaiyan, Fan Yun
Department of Oncology, The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.
Department of Medical Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.
Int J Cancer. 2023 Jun 1;152(11):2243-2256. doi: 10.1002/ijc.34346. Epub 2022 Nov 29.
Extensive-stage small-cell lung cancer (ES-SCLC) is regarded as a refractory carcinoma associated with extremely rapid disease progression. After more than three decades without clinical advances, research on immune checkpoint inhibitors (ICIs) combined with platinum-based chemotherapy has led to the first treatment breakthrough, establishing a new standard for the first-line treatment of ES-SCLC. Further studies have extensively evaluated small-molecule antiangiogenic drugs, PARP inhibitors, as well as lurbinectedin in SCLC and have demonstrated some benefit, although no breakthroughs have been made. In addition, newer therapeutic strategies with targeted agents, novel chemotherapeutics and immunotherapies are evolving as they are being actively explored and hold promise for patients with this disease. Notably, the preliminary identification of SCLC molecular subtypes driven by the expression of dominant transcription factors with RNA sequencing profiles has made it possible to identify molecularly tailored therapeutic approaches, which increases the potential for individualized precision treatment of SCLC. In this review, we summarize recent research advances in ES-SCLC, outline the current management of this disease and reflect on directions for future development.
广泛期小细胞肺癌（ES-SCLC）被认为是一种难治性癌症，疾病进展极快。在三十多年没有临床进展之后，关于免疫检查点抑制剂（ICI）联合铂类化疗的研究带来了首个治疗突破，确立了ES-SCLC一线治疗的新标准。进一步的研究广泛评估了小分子抗血管生成药物、PARP抑制剂以及鲁比卡丁在小细胞肺癌中的作用，虽未取得突破，但已显示出一定益处。此外，随着靶向药物、新型化疗药物和免疫疗法等更新的治疗策略不断被积极探索，它们为该病患者带来了希望。值得注意的是，通过RNA测序图谱对由显性转录因子表达驱动的小细胞肺癌分子亚型进行初步鉴定，使得识别分子靶向治疗方法成为可能，这增加了小细胞肺癌个体化精准治疗的潜力。在本综述中，我们总结了ES-SCLC的最新研究进展，概述了该病的当前治疗情况，并对未来的发展方向进行了思考。
