Lung Cancer, Small Cell: Chemotherapy

Because small cell lung cancer spreads quickly from the lungs to other parts of the body, the primary treatment is chemotherapy. Chemotherapy is a drug or combination of drugs that travels throughout the body to kill cancer cells wherever they might be.

Chemotherapy for small cell lung cancer is given either alone or in combination with radiation therapy. At Memorial Sloan-Kettering, the  approach your doctors recommend will depend on the stage of your disease.

• People with limited stage small cell lung cancer simultaneously receive a combination of chemotherapy and radiation therapy to shrink the tumor.
• People with extensive stage cancer receive chemotherapy only. This is because radiation therapy is highly targeted and is not effective when the cancer has spread from the lung where the cancer began to other parts of the body.

Initial chemotherapy for all patients with small cell lung cancer includes the combination of the drug etoposide with a platinum agent (either cisplatin or carboplatin).

Currently, there is no approved chemotherapy drug for patients after completion of this initial treatment. And unfortunately, all patients with extensive stage small cell lung cancer and the majority of patients with limited stage small cell lung cancer experience a relapse, meaning that their cancer returns after primary therapy. Doctors at Memorial Sloan-Kettering are helping to lead efforts to find new drugs for patients whose cancer has recurred following standard treatment.

New Drug Approaches

Memorial Sloan-Kettering is testing new chemotherapy drugs for the treatment of small cell lung cancer. One is temozolomide, which is currently approved for the treatment of primary brain tumors (tumors that begin in the brain). The drug belongs to a family of drugs known as alkylating agents, which damage a tumor cell’s DNA, causing it to die. These agents are known to be useful in small cell lung cancer.

We are also testing drugs known as Bcl-2 inhibitors, which work by blocking signals that make cancer cells grow continuously. One Bcl-2 inhibitor we are studying is obatoclax, in combination with topotecan, a standard drug in the treatment of small cell lung cancer.

Other drugs we are testing include:

• ADI-PEG 20, a protein therapeutic that has been shown to be effective in early trials of metastatic melanoma and hepatocellular carcinoma
• a vaccine that is designed to trigger an immune response against small cell lung cancer and reduce the risk of recurrence

Memorial Sloan-Kettering researchers are also conducting studies to investigate the molecular factors that lead to small lung cancer. Understanding these factors holds hope for developing targeted therapies – a new class of drugs that can stop the progression of cancer by binding to specific molecular targets.

For many patients the best treatment strategy is to enroll in a clinical trial that tests new drugs. These drugs can be tested either alone or in combination with more established treatments. By choosing Memorial Sloan-Kettering for your care, you may gain access to new treatments that are not widely available elsewhere. Visit Our Clinical Trials for an up-to-date listing of lung cancer clinical trials that are currently enrolling new patients.