![]() That may or may not be the case in small cell lung cancer, because we’re still trying to see which biomarkers would suggest a better response to treatment for these patients. There is a high tumor mutational burden, with known response to immune checkpoint inhibitors. The premise of immunotherapy in small cell lung cancer is that there tends to be high tumor mutational burden, which may be associated with the use of tobacco in these patients. But still, we use it in the first-line setting in combination with chemotherapy and immune therapies, such atezolizumab and durvalumab. In 2021, there was withdrawal of approval of nivolumab and pembrolizumab, which was in the subsequent-line setting. Subsequently, we had an approval of lubenetidin, in the second-line setting and rilaciclib in the first-line setting to avoid myelosuppression related to the chemotherapy. Initially, we started with nivolumab and pembrolizumab, which are anti-PD-1 agents, and gradually we had improved approval of atezolizumab in 2019, and then durvalumab in 2020, in the first-line setting. Then, we started to see the role of immunotherapy for these patients. The progress in the treatment for this type of cancer has been at a standstill for a number of years, until in about 2018. They respond, and when they relapse, we have limited therapies to offer them with not much promise. This disease has been called recalcitrant, and for a good reason, because most patients relapse after the generally favorable response in the first-line setting. Traditionally, the second-line treatment is with topotecan, and that works in platinum-sensitive patients, has a response rate of about 20%, but has a more modest improvement in survival over best supportive care. However, that response is usually short-lived. We see responses in more than 60% of the patients. In the first-line setting, patients respond well with platinum etoposide. Small cell lung cancer is a highly proliferative, aggressive form of lung cancer that carries a poor prognosis for close to 40 years, and the preferred decades old treatment is platinum etoposide. The median survival is limited to approximately 10 months. Sharma: Nearly 2-thirds of the patients with small cell lung cancer present with extensive-stage of small cell at diagnosis, and the prognosis is usually poor with a 5-year survival rate of less than 7%. TARGETED ONCOLOGY: What advances have been seen in the SCLC space over recent years? Sharma also discussed ongoing clinical trials that may bring new therapies in the near future. In the interview, Sharma discussed frontline treatment options for SCLC and data supporting their use. These investigational agents include serpulilimab (HLX10), and toripalimab. Moreover, agents being investigated in clinical trials are show promising to become the next available strategies for first-line SCLC. Some of the treatments for SCLC include durvalumab (Imfinzi) for the treatment of patients with extensive stage-SCLC and lurbinectedin (Zepzelca) for the treatment of patients with metastatic SCLC. This characterization of the small cell lung cancer is vital in exploring further treatment strategies for this tumor," said Sharma, a medical oncologist, and hematologist at Cancer Treatment Centers of America Atlanta, in an interview with Targeted Oncology™. We know, in general, a cold tumor may respond to chemotherapy whereas a hot tumor may have better responses to the immunotherapy. ![]() “Small cell lung cancer is now being looked at with a molecular characterization based on whether it's a cold tumor or a hot tumor. A collection of chemotherapy, targeted therapy, and immunotherapy agents are improving outcomes for patients with small cell lung cancer (SCLC) in the first-line setting.Īs more understanding of biomarkers in SCLC is spread in the oncology community, outcomes for patients with SCLC may become more similar to the non–small cell lung cancer population, according to Nitika Sharma, MD. ![]()
0 Comments
Leave a Reply. |