Treatment of metastatic small-cell lung cancer in 2012

Systemic chemotherapy plays a major role in the management of patients with Stage IV small-cell lung cancer(SCLC). Despite strong initial chemosensitivity, majority of patients relapse within a few months and few patients survive more than a year. Spontaneous prognosis is wrong for at least six weeks. Little progress in the management of this cancer is emerging after many years without real success since the demonstration of efficacy of first-line of cisplatinetoposide combination thirty years ago and the efficacy topotecan as secondline treatment in 2006. Prophylactic cranial irradiation prolongs overall survival in patients who had a response to chemotherapy. Better knowledge in understanding the biology of SCLC has led to the identification of essential signaling pathways but even the prospect of new therapeutic approaches is littered with failures and disappointments. New targets continue to be identified and treatments are currently being evaluated. The inclusion of patients in clinical trials is necessary to improve the survival of patients with SCLC.