1. Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2017.71
Figure 1 Timeline of therapeutic advances for small-cell lung cancer (SCLC)
Figure 1 | Timeline of therapeutic advances for small-cell lung cancer (SCLC). This timeline illustrates the paucity of new treatment options for patients with SCLC over the past three decades. The red-shaded boxes represent standard-of-care therapies that have been approved by the FDA; the yellow-shaded boxes represent therapies that have been recommended by the National Comprehensive Cancer Network (NCCN)20, but are not currently approved by the FDA. Since 1985, the cisplatin and etoposide chemotherapy regimen has remained the standard-of-care first-line systemic treatment for patients with extensive-stage (ES)-SCLC. Subsequent regimens, in which carboplatin or irinotecan substitute for cisplatin or etoposide, respectively, have comparable effectiveness, but differing toxicity profiles. Second-line therapies that are recommended in the NCCN guidelines include topoisomerase inhibitors, taxols, alkylating agents, and, since 2016, immunotherapy, although only topotecan is approved by the FDA for use in this setting. For limited-stage (LS)-SCLC, radiation treatment early in the course of chemotherapy is recommended, classically at a total dose of 45 Gy delivered in 30 twice-daily (b.i.d.) fractions of 1.5 Gy (over the course of 3 weeks), with additional prophylactic cranial irradiation (PCI). More recently, thoracic irradiation has been shown to be of benefit for some patients with ES-SCLC; however, the role of thoracic radiation and PCI in the treatment of ES-SCLC remains controversial.
Sabari, J. K. et al. (2017) Unravelling the biology of SCLC: implications for therapy
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