By Rashmi Acharya, MS, Coordinator, Science & Research, GO2 for Lung Cancer

1. What is Small Cell Lung Cancer?

Small cell lung cancer (SCLC) is a type of lung cancer named for the very small, oval shaped cancer cells seen under a microscope. It is a rapidly growing type of cancer seen in 13-15% of all lung cancer patients. Because it is often diagnosed in later stages, the 5-year survival rate has historically been quite low (at 6%). There are, however, new options that will hopefully improve these numbers.

2. How is Small Cell Lung Cancer treated?

Limited (Stages I-III) stage SCLC is typically treated with some combination of surgery, chemotherapy, and radiation. Chemotherapy had been the standard treatment for extensive SCLC for three decades. In the last two years, clinical trials like IMpower133 and CASPIAN, showed immunotherapy and chemotherapy in combination was a better first treatment for extensive stage SCLC. Based on this, the immunotherapy drugs Tecentriq (atezolizumab) and Imfinzi (durvalumab) were swiftly approved as first treatments along with chemotherapy for treatment of extensive stage. Currently, extensive (Stage IV) stage SCLC is treated with immunotherapy and chemotherapy combination, with or without radiation.

SCLC tends to respond well to the first course of treatment, but that typically only lasts for about 1-2 years. Treatment options after that are limited, which can make cancer that has started to grow again harder to treat. Currently, Zepzelca (lurbinectedin) and Hycamtin (topotecan) are approved for treatment of SCLC that has started growing again after a first treatment. Several other drugs, including Temodar (Temozolomide) and Camptosar (irinotecan), are being tested in clinical trials.

3. How can clinical trials help patients with SCLC?

Clinical trials can offer the most cutting-edge treatments for people with SCLC while also receiving the best care possible under the close supervision of the clinical trial medical team.

Several clinical trials are looking at molecules expressed in SCLC tumor cells, like DLL3, SLFN11, and cMYC, as biomarkers for targeted therapy for SCLC. These markers help drugs target and kill cancer cells that carry them. Other studies have found that some drugs can help improve the effects of different treatments. For example,  a type of drugs called PARP inhibitors, when given with immunotherapy, can improve the tumor’s response to treatment. Several other drugs may have potential benefit for SCLC. (See A More Promising and Personalized Future for SCLC Patients for more information.) Multiple new chemotherapy and immunotherapy treatments are also being tested in both limited and extensive stage SCLC.

Clinical trials produce valuable medical data that physicians use to make informed treatment plans that fit the patient’s needs best. This information is also helpful to minimize side effects of treatment as patient experiences are closely monitored and reported during clinical trials. Clinical trials are extremely important to understand SCLC better, to discover new treatments, and to improve current treatments.

Subscribe to the Magnifying LeNS to keep up-to-date with the most recent advances in lung cancer and ongoing clinical trials. And call 1-800-298-2436 or email support@go2.org to ask to speak to a LungMATCH Navigator for help finding appropriate clinical trials.