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2015 ; 4
(5
): 533-44
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Novel therapies in small cell lung cancer
#MMPMID26629422
Mamdani H
; Induru R
; Jalal SI
Transl Lung Cancer Res
2015[Oct]; 4
(5
): 533-44
PMID26629422
show ga
Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor of the lung
with a tendency to metastasize widely early in the course of the disease. The VA
staging system classifies the disease into limited stage (LS) which is confined
to one hemithorax and can be included into one radiation field or extensive stage
(ES) which extends beyond one hemithorax. Current standard of care is concurrent
chemoradiation for LS disease and chemotherapy alone for ES disease. Only a
quarter of patients with LS disease will be cured with current standard
treatments and majority of the patients ultimately succumb to their disease. A
very complex genetic landscape of SCLC accounts for its resistance to
conventional therapy and a high recurrence rate, however, at the same time this
complexity can form the basis for effective targeted therapy for the disease. In
recent years, several different therapeutic strategies and targeted agents have
been under investigation for their potential role in SCLC. Several of them
including EGFR TKIs, BCR-ABL TKIs, mTOR inhibitors, and VEGF inhibitors have been
unsuccessful in showing a survival advantage in this disease. Several others
including DNA repair inhibitors, cellular developmental pathway inhibitors,
antibody drug conjugates (ADCs), as well as immune therapy with vaccines,
immunomodulators, and immune checkpoint inhibitors are being tested. So far, none
of these agents are approved for use in SCLC and the majority are in phase I/II
clinical trials, with immune checkpoint inhibitors being the most promising
therapeutic strategy. In this article, we will discuss these novel therapeutic
agents and currently available data in SCLC.