CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
School of Basic Medical Sciences, Peking University, Beijing, China.
Cancer Metastasis Rev. 2024 Nov 25;44(1):5. doi: 10.1007/s10555-024-10220-8.
Small cell lung cancer (SCLC) represents an aggressive neuroendocrine (NE) tumor within the pulmonary region, characterized by very poor prognoses. Druggable targets for SCLC remain limited, thereby constraining treatment options available to patients. Immuno-chemotherapy has emerged as a pivotal therapeutic strategy for extensive-stage SCLC (ES-SCLC), yet it fails to confer significant efficacy in cases involving liver metastases (LMs) originating from SCLC. Therefore, our attention is directed towards the challenging subset of SCLC patients with LMs. Disease progression of LM-SCLC patients is affected by various factors in the tumor microenvironment (TME), including immune cells, blood vessels, inflammatory mediators, metabolites, and NE substances. Beyond standard immuno-chemotherapy, ongoing efforts to manage LMs in SCLC encompass anti-angiogenic therapy, radiotherapy, microwave ablation (MWA) / radiofrequency ablation (RFA), trans-arterial chemoembolization (TACE), and systemic therapies in conjunction with local interventions. Prospective experimental and clinical investigations into SCLC should prioritize precise and individualized approaches to enhance the prognosis across distinct patient cohorts.
小细胞肺癌（SCLC）是肺部具有侵袭性的神经内分泌（NE）肿瘤，预后极差。SCLC 的治疗靶点仍然有限，因此限制了患者的治疗选择。免疫化疗已成为广泛期 SCLC（ES-SCLC）的重要治疗策略，但在源自 SCLC 的肝转移（LM）病例中，它并不能显著提高疗效。因此，我们关注的是伴有 LM 的 SCLC 患者这一具有挑战性的亚组。LM-SCLC 患者的疾病进展受到肿瘤微环境（TME）中各种因素的影响，包括免疫细胞、血管、炎症介质、代谢物和 NE 物质。除了标准的免疫化疗之外，目前对 SCLC 中 LM 的治疗还包括抗血管生成治疗、放疗、微波消融（MWA）/射频消融（RFA）、经动脉化疗栓塞（TACE）以及与局部干预相结合的全身治疗。对 SCLC 的前瞻性实验和临床研究应优先考虑精确和个体化的方法，以提高不同患者群体的预后。
