Current standards of care in small-cell and non-small-cell lung cancer

Joan H. Schiller

Research output: Contribution to journalArticle

140 Citations (Scopus)

Abstract

Lung cancer is the leading cause of cancer-related death in the United States, accounting for over 30% of cancer deaths in men and 25% in women. Small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) are uniformly aggressive tumors, with rates of regional or distant metastases at diagnosis as high as 70%. Because the majority of these tumors are unresectable, patients with relatively good performance status receive platinum-based chemotherapy. Although no treatment consensus exists, currently recommended regimens for SCLC include PE (cisplatin and etoposide), CAV (cyclophosphamide, doxorubicin, and vincristine), CAE (cyclophosphamide, doxorubicin, and etoposide), and CAVE (cyclophosphamide, doxorubicin, vincristine, and etoposide). Of these, the PE regimen has been widely accepted in the United States, although CE (carboplatin and etoposide) provides better tolerability. For NSCLC, standard chemotherapy regimens have included platinum-based therapy (cisplatin and a vinca alkaloid or PE). Data from recent studies suggest that the addition of paclitaxel to platinum modestly improves tumor response and survival in NSCLC. Although SCLC and NSCLC are both responsive to first-line chemotherapy, most patients relapse and die from their disease, with 5-year survival rates of approximately 15%. Given the disappointing survival rates associated with SCLC and NSCLC, the introduction of new cytotoxic agents has been eagerly anticipated. Evidence of improved response and extended survival is mounting for various combinations of established regimens (e.g., PE) with newer drugs exhibiting novel mechanisms of action and single-agent anti-tumor activity, such as gemcitabine, paclitaxel, docetaxel, vinorelbine, and topotecan. This article reviews the current standards of care in SCLC and NSCLC, and introduces the potential role of newer agents given in combination with standard chemotherapy.

Original languageEnglish (US)
Pages (from-to)3-13
Number of pages11
JournalOncology
Volume61
Issue numberSUPPL. 1
DOIs
StatePublished - 2001

Fingerprint

Standard of Care
Non-Small Cell Lung Carcinoma
Small Cell Lung Carcinoma
Etoposide
Platinum
Doxorubicin
Cyclophosphamide
Drug Therapy
Neoplasms
docetaxel
Vincristine
gemcitabine
Paclitaxel
Cisplatin
Survival Rate
Vinca Alkaloids
Topotecan
Survival
Carboplatin
Cytotoxins

Keywords

  • Etoposide
  • Non-small-cell lung cancer
  • Paclitaxel
  • Platinum-based therapy
  • Small-cell lung cancer
  • Topotecan
  • Vinorelbine

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Current standards of care in small-cell and non-small-cell lung cancer. / Schiller, Joan H.

In: Oncology, Vol. 61, No. SUPPL. 1, 2001, p. 3-13.

Research output: Contribution to journalArticle

Schiller, Joan H. / Current standards of care in small-cell and non-small-cell lung cancer. In: Oncology. 2001 ; Vol. 61, No. SUPPL. 1. pp. 3-13.
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