Pitfalls With Treatment in the SCLC Space

Gene G. Finley, MD, discusses some of the challenges seen when treating patients with small cell lung cancer.

Gene G. Finley, MD, medical oncologist at Allegheny Clinic Medical Oncology of Allegheny Health Network, discusses some of the challenges seen when treating patients with small cell lung cancer (SCLC).

For experts working in the SCLC field, immunotherapy (IO) has sparked interest over recent years. With this, new improvements and treatment options have been brought to the table.

Still, questions remain in SCLC as options are lacking, especially for patients who relapse. Finley attributes this to most of the second-line treatments being unsatisfactory.

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0:08 | One is, what do you do with the extensive-stage patient, which most of them are, who relapses, because the treatments in the second-line setting are unsatisfactory. Lurbinectedin [Zepzelca] was a bit of an improvement and there's other single-agent chemotherapy, but we haven't had much mileage out of reintroducing immunotherapy, if it's been given in the first-line setting.

0:45 | In terms of limited disease, I think we're doing quite well and are looking forward to the time where we will have other drugs to give after chemoradiation. The way it is now, you incorporate the radiation in first-line therapy with platinum-based doublets for topotecan for example. Then after that, it's mainly an observational strategy. Most patients will stay in remission and many end up relapsing. Then, we're looking again at IO or chemotherapy with IO depending on the duration and the length of their admission. I think there's room to introduce immunotherapy or other drugs and in the post-chemotherapy radiation setting. I know that's of interest and people are designing trials in that space.