Small cell lung cancer: will recent progress lead to improved outcomes?

Small cell lung cancer (SCLC) is an aggressive neuroendocrine malignancy with a unique natural history characterized by a short doubling time, high growth fraction, and early development of widespread metastases. Although a chemotherapy- and radiation-sensitive disease, SCLC typically recurs rapidly...

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Bibliographic Details
Published in:Clinical cancer research 2015-05, Vol.21 (10), p.2244-2255
Main Authors: Pietanza, M Catherine, Byers, Lauren Averett, Minna, John D, Rudin, Charles M
Format: Article
Language:English
Subjects:
Animals
Antineoplastic Agents - pharmacology
Antineoplastic Agents - therapeutic use
Epigenesis, Genetic
Gene Expression Regulation, Neoplastic
Humans
Lung Neoplasms - drug therapy
Lung Neoplasms - genetics
Molecular Targeted Therapy
Small Cell Lung Carcinoma - drug therapy
Small Cell Lung Carcinoma - genetics
Treatment Outcome
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Summary:Small cell lung cancer (SCLC) is an aggressive neuroendocrine malignancy with a unique natural history characterized by a short doubling time, high growth fraction, and early development of widespread metastases. Although a chemotherapy- and radiation-sensitive disease, SCLC typically recurs rapidly after primary treatment, with only 6% of patients surviving 5 years from diagnosis. This disease has been notable for the absence of major improvements in its treatment: Nearly four decades after the introduction of a platinum-etoposide doublet, therapeutic options have remained virtually unchanged, with correspondingly little improvement in survival rates. Here, we summarize specific barriers and challenges inherent to SCLC research and care that have limited progress in novel therapeutic development to date. We discuss recent progress in basic and translational research, especially in the development of mouse models, which will provide insights into the patterns of metastasis and resistance in SCLC. Opportunities in clinical research aimed at exploiting SCLC biology are reviewed, with an emphasis on ongoing trials. SCLC has been described as a recalcitrant cancer, for which there is an urgent need for accelerated progress. The NCI convened a panel of laboratory and clinical investigators interested in SCLC with a goal of defining consensus recommendations to accelerate progress in the treatment of SCLC, which we summarize here.
ISSN:1078-0432
1557-3265
DOI:10.1158/1078-0432.ccr-14-2958