Small cell lung cancer: guidelines for treatment

This paper provides an update on the current guidelines for the diagnosis and treatment of small-cell lung cancer. The paper summarized updates to immune therapy, systemic therapy, and radiotherapy.

Small cell lung cancer (SCLC) accounts for about 14% of all lung cancers. Nearly all of these cases are directly caused by smoking cigarettes. SCLC is very difficult to treat. Only 1/3 of patients with SCLC start treatment before it has spread. It grows very fast and spreads quickly. SCLC is usually very responsive to chemotherapy and radiotherapy. Recently, there have been updates to types of treatment.

This paper pulls together information and guidelines from a number of other pieces of research. 

The paper recommends that people diagnosed with SCLC stop smoking immediately. They noted that only 2-5% of patients with SCLC will be able to have surgery to remove the tumor. Chemotherapy is recommended for all patients who had surgery.

Radiation therapy has improved survival for patients with SCLC. The radiation therapy is aimed at the chest. Patients who underwent radiation therapy had a 14% reduction in mortality. The paper discussed a new kind of treatment where the brain is subjected to radiation therapy. This is because SCLC commonly spreads to the brain. By doing radiation therapy before the cancer has got to the brain (prophylactic cranial irradiation), it is thought it might prevent cancer cells from sticking and creating new tumors in the brain. More research is going on into this area. It is common for patients to relapse.

Nivolumab (Opdivo), ipilimumab (Yervoy), and pembrolizumab (Keytruda) are medications used to treat SCLC. They work by stimulating the immune system to attack cancer cells. The recommended doses of the medications have been slightly changed due to side effects.

The paper provided an update on the current guidelines for the diagnosis and treatment of small-cell lung cancer.