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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2007 December;46(4):275-86
Small cell lung cancer: current therapeutic strategies
Edelmann M., Huber R. M.
Department of Pulmonary Medicine Medizinische KlinikCampus Innenstadt Ludwig-Maximilians-University Munich Munich, Germany
Lung cancer has become the most frequent malignancy leading to the death of the patient in a short time. Because of unspecific symptoms like coughing, changed coughing patterns, or weight loss and imperfect screening methods, the diagnosis usually is made only late in the course of the disease, with 70% of the patients being in stage IIIb or worse. small cell lung cancer (SCLC) is one histological subtype accounting for 15-20% of all lung cancer cases. It is almost completely caused by inhalative smoking and therefore would be easily preventable. Because of intense research interest, the chemotherapeutical regimens have been tested extensively, but overall survival rates are still only marginally higher than a decade ago. The platinum-based therapies are now well established. To improve the outcome for the patients, using the good chemo sensitivity of the SCLC cells is the most promising approach. After the first step, the control over the local growth, the next goal is a prolonged progression-free survival by reducing resistance of tumour cells against chemotherapy. Even more research interest is invented in new targeted therapies. Right now, they offer therapeutic options and are tested in clinical trials. Multimodality-therapy combining thoracic irradiation with intense chemotherapy is the gold standard for first line therapy in SCLC, stage I – IIIb. Chemotherapy is also the mainstay in second line therapy. Here, newer substances have shown a significant benefit.