Chemotherapy is one of the main treatments for small cell lung cancer (SCLC). Your doctor will choose a chemotherapy regimen for you based on your tumor stage, how well you tolerate it, and your wishes.
Related reading:
Here is a brief description of the commonly used chemotherapy regimens for SCLC.
I. Limited-stage SCLC
If the stage is early (tumor diameter does not exceed 5 cm, no invasion of important blood vessels, organs, etc., no lymph nodes and distant metastases), surgery is followed by adjuvant chemotherapy or radiotherapy with EP (etoposide + cisplatin/carboplatin) regimen; if surgery is not possible, doctors usually do simultaneous radiotherapy.
II. Extensive stage SCLC
There is usually a combination of chemotherapy-based therapy.
The EP regimen is the classic regimen for first-line treatment, and doctors sometimes choose the irinotecan + cisplatin/carboplatin regimen.
If relapse or progression occurs within 6 months after first-line chemotherapy, second-line chemotherapy can be selected with topotecan, or in clinical trials; if disease progression occurs beyond 6 months, the initial regimen can be selected again.
Clinically used first-line chemotherapy regimens for SCLC
| Chemotherapy regimen |
Duration of drug administration (days) |
Time and period |
|
1~3 1 |
21-day cycle, 4 to 6 cycles | |
|
1 to 3 1 |
21-day cycle, 4 to 6 cycles | |
|
1,8,15 1 |
28 days for one cycle, 4 to 6 cycles | |
|
1,8 1,8 |
21 days for one cycle, 4 to 6 cycles |
|
|
IC: Irinotecan Carboplatin |
1,8,15 1 |
28 days for one cycle, 4 to 6 cycles |
Commonly used clinical second-line chemotherapy regimens for SCLC
| chemotherapy regimen | Duration of drug administration (days) | Time and period |
|
Topotecan Oral |
1~5 1~5 |
21 days for one cycle |
Extended reading
I. What is first-line chemotherapy?
The standard treatment regimen that doctors first recommend for use is first-line chemotherapy. For patients treated with surgery, adjuvant chemotherapy received if a relapse occurs within 6 months of the end of chemotherapy is also considered first-line therapy.
It is worth noting that for patients undergoing radical surgery, preoperative neoadjuvant therapy, postoperative adjuvant therapy (recurrence beyond 6 months), and concurrent radiotherapy are not considered first-line chemotherapy.
II. What is second-line chemotherapy?
A treatment regimen that is recommended to be changed by the doctor after failure of first-line chemotherapy is second-line chemotherapy. There is also a situation where the disease is stable after first-line treatment but progresses after a period of time, and then the doctor recommends a different regimen, which is also second-line chemotherapy.
Co-authors: Dr. Yue-Li Sun, Guangdong Provincial People’s Hospital, Guangdong Lung Cancer Institute, Dr. Xiao-Xiao Peng, Dr. Ming-Feng Zhang