The Chinese People's Liberation Army

Small cell lung cancer (SCLC), which accounts for 15% to 17% of all lung cancers, is one of the leading causes of cancer-related death worldwide. More than 130 000 new diagnoses of SCLC and 100 000 deaths from the disease were estimated to have occurred in China in 2013. The existing guidelines of SCLC therapeutic principles differ by region. In recent years, new immunotherapy and targeted therapy treatments have been lacking. In order to understand the current status of SCLC treatment in more detail, we identified the similarities and differences among the latest National Comprehensive Cancer Network Clinical Practice Guidelines for SCLC, the Chinese Society of Clinical Oncology Lung Cancer Guidelines, and the European Society for Medical Oncology Clinical Practice Guidelines for Metastatic SCLC, and present a reference of treatment strategies that should prove beneficial for the treatment of patients with SCLC.

Comparison and discussion of the treatment guidelines for small cell lung cancer.

Treatment and outcome of 432 patients with extensive-stage small cell lung cancer in first, second and third line - Results from the prospective German TLK cohort study.

https://nottingham-repository.worktribe.com/preview/3839973/Clean%20manuscript.pdf

A systematic review of survival following anti-cancer treatment for small cell lung cancer

Winning the battle, but losing the war: mechanisms and morphology of cancer-therapy-associated cardiovascular toxicity.

Extensive-disease small-cell lung cancer (ED-SCLC) is characterized by rapid progression and relapse, despite high initial response rates to chemotherapy. The primary objective of this trial was to demonstrate the non-inferiority of amrubicin and cisplatin (AP) combination therapy compared with the standard first-line regimen of etoposide and cisplatin (EP) for previously untreated ED-SCLC in a Chinese population. When non-inferiority was verified, the objective was switched from non-inferiority to superiority. From June 2008 to July 2010, 300 patients were enrolled and randomly assigned at a 1:1 ratio to AP and EP groups. AP-treated patients received cisplatin (60 mg/m2, day 1) and amrubicin (40 mg/m2, days 1–3) once every 21 days. EP-treated patients received cisplatin (80 mg/m2, day 1) and etoposide (100 mg/m2, days 1–3) once every 21 days. Treatment was continued for four to six cycles, except in cases of progressive disease or toxicity, and patient refusal. Median overall survival (OS) for AP vs. EP treatment was 11.8 vs. 10.3 months (p = 0.08), respectively, demonstrating non-inferiority of AP to EP (AP group: 95 % confidence interval for hazard ratio 0.63–1.03 months). Median progression-free survival and overall response rates for AP vs. EP groups were 6.8 vs. 5.7 months (p = 0.35) and 69.8 % vs. 57.3 %, respectively. Drug-related adverse events in both groups were similar, with neutropenia being the most frequent (AP 54.4 %; EP 44.0 %). Leukopenia, pyrexia, and fatigue were more prevalent in the AP group, but all were clinically reversible and manageable. AP therapy demonstrated non-inferiority to EP therapy, prolonging OS for 1.5 months, but this difference was not statistically significant; thus we propose AP as a promising treatment option for ED-SCLC in China. This trial was registered on 10 April 2008 (ClinicalTrials.gov NCT00660504
 ).

/pdf/randomized-phase-iii-trial-of-amrubicin-cisplatin-versus-3zhqwh3h55.pdf

Yunzhong Zhu

Papers

Randomized phase III trial of amrubicin/cisplatin versus etoposide/cisplatin as first-line treatment for extensive small-cell lung cancer