Small Cell Lung Cancer (Chemo) 9% success rate.
Current treatment versus Amyloxine® case study..
| Small cell lung cancer is an aggressive disease that is usually disseminated at the
time of initial diagnosis. The natural history is characterized by a rapid and relentless
clinical course with a median survival measured in weeks to months, depending on the
extent of the disease. SCLC exhibits considerable sensitivity to a number of cytotoxic
agents and systemic combination chemotherapy is the cornerstone of treatment. Most
regimens used today include Etoposide and a platinum analog, either Cisplatin or Carboplatin. In patients with limited-stage disease, thoracic irradiation is also delivered; this provides improved local control and meta-analysis has shown that it also contributes to a survival benefit. Overall response rates are in the range of 70% - 90% with complete responses as high as 50% in those patients with limited disease and up to 30% in those with extensive SCLC. More complex treatment regimens employing additional cytotoxic drugs, dose intensification, alternating regimens (as in the above patient), and complicated weekly intensive regimens have yet to consistently demonstrate significant improvement in survival over standard therapy. Median survival for extensive SCLC is approximately 8-10 months and for a limited SCLC approximately 12-16 months. Recent pilot studies using concurrent chemotherapy with twice daily irradiation have shown improved overall (9%) and complete (approximately 8-9%) response rates and median survival approximately two years. The advantage twice daily fractionation over single daily irradiation was not confirmed in a recent prospective randomized trial. SCLC has a propensity to metastasize to the central nervous system. Patients who obtain complete response to chemotherapy, and thus live longer, are at particular risk to develop brain metastases. This complication can be reduced significantly with prophylactic cranial irradiation (PCI). Although there have been concerns that some patients may develop radiation-related neuropsychological disturbances, recent prospective, randomized data suggest that PCI can reduce the risk of brain metastases without a significant increase in treatment-related complications. SCLC is almost invariably associated with a history of smoking and these patients are also at considerable risk for other tobacco-related malignancies. Although late relapses from SCLC can occur, recurrence after a 5-year disease-free interval are distinctly unusual. Indeed, in long-term survivors of SCLC there is an increasing risk of second aerodigestive cancers and there is a greater likelihood of succumbing to a second primary tumor than from recurrent SCLC. Those patients who appear to have been cured of SCLC would be good candidates to target for chemoprevention trials. Amyloxine® Study Breast Cancer Treatment |