New Promising Drugs for Small Cell Lung Cancer


Any type of advanced lung cancer is bad news, but a diagnosis of small cell lung cancer (SCLC) is a particularly grim one to receive. About 30 years have passed since any new treatments for SCLC were developed, and patients’ responses to standard chemotherapy with etoposide and cisplatin are short-lived. Hopefully, this will change soon.

We begin this post with the immune checkpoint inhibitors, a type of immunotherapy that is explored in seemingly every type of cancer, including SCLC. Reports from two clinical trials of these drugs were recently made available at two meetings on lung cancer treatment. Continue reading…


Checkpoint Inhibitors Show Promise in SCLC, Mesothelioma

“Immune checkpoint inhibitors have demonstrated encouraging results for patients with small cell lung cancer (SCLC) and mesothelioma, two aggressive thoracic malignancies with few options, according to a presentation by M. Catherine Pietanza, MD, at the 10th Annual New York Lung Cancer Symposium.

“ ‘The antibodies to CTLA-4, PD-1, and PD-L1 can be safely given to these patients. Responses are seen and are durable. There is a benefit in both platinum-sensitive and platinum-refractory SCLC,’ said Pietanza, a medical oncologist at Memorial Sloan Kettering Cancer Center.

“Chemotherapy has traditionally been the treatment of choice for most patients with SCLC and mesothelioma beyond the frontline setting. However, outcomes are poor with these therapies, specifically for SCLC, where the median survival following second-line therapy ranges from 6 to 9 months.”


CRT May Be Preferred Strategy for Elderly with Lung Cancer

“Chemoradiotherapy (CRT) is associated with survival benefit over chemotherapy (CT) alone for elderly patients with limited-stage small-cell lung cancer, according to a study published online Oct. 19 in the Journal of Clinical Oncology.

“Christopher D. Corso, M.D., Ph.D., from the Yale University School of Medicine in New Haven, Conn., and colleagues examined outcomes for elderly patients (≥70 years) treated with CT versus CRT. Data were included for 8,637 patients with limited-stage small-cell lung  in the National Cancer Data Base between 2003 and 2011.

“The researchers found that 43.7 and 56.3 percent of the patients received CT and CRT, respectively. CRT receipt was less likely with increasing age, clinical stage III disease, female sex, and the presence of medical comorbidities (all P < 0.01). Compared with CT, CRT use correlated with increased overall survival on univariate and multivariate analysis (median overall survival, 15.6 versus 9.3 months). Survival benefit associated with CRT was confirmed in a propensity score-matched cohort of 6,856 patients (hazard ratio, 0.52; P < 0.001). In subset analysis, patients who were alive at four months after diagnosis had a  with concurrent versus sequential CRT (median overall survival, 17.0 versus 15.4 months; log-rank P = 0.01).”


Chemotherapy Use, Survival in SCLC Increased Over 20 Years

“A study looking at trends from 1985 to 2005 found that overall survival has increased in Medicare patients with small-cell lung cancer (SCLC), and that treatment with chemotherapy is associated with improved survival.

“ ‘Although the proportion of cases diagnosed as SCLC has declined from approximately 20% to 13%, this subset is still a major cause of disease burden with close to 30,000 new cases annually,’ wrote study authors led by Madhusmita Behera, PhD, of Emory University in Atlanta. The use of chemotherapy in real-world populations is limited by significant toxicity, they added, and whether recommended therapies are adopted has not been well studied.

“The new study used the SEER database to study trends in outcome and treatment; it included 47,351 eligible patients divided into 5-year intervals, with 1985–1990 used as the baseline. Results were published online ahead of print in Cancer.”


COPD Heightens Deadly Lung Cancer Risk in Smokers

“Smokers who have chronic obstructive pulmonary disorder (COPD) may face nearly twice the risk of getting small cell lung cancer (SCLC)—the deadliest form of lung cancer—than smokers who don’t have COPD, according to a large worldwide study led by researchers at the Harvard T.H. Chan School of Public Health.

“The study was published online September 24, 2015 in EBioMedicine.

“The new study—the largest-ever epidemiologic study of SCLC—is the first to look at how much COPD, a progressive disease that makes it hard to breathe, increases smokers‘ risk of getting SCLC. Although it’s long been known that smoking is a major risk factor for lung cancer, the new study estimates the risk more precisely than before.”


First 'Targeted' Treatment for Small Cell Lung Cancer Shows Promise

“Small cell lung cancer (SCLC) is an aggressive disease that is difficult to treat and is frequently only diagnosed when it has spread to other parts of the body (metastasised). Five-year survival rates in SCLC, which accounts for about 14% of all lung cancers, are very low, at only six percent. But today US researchers will present two novel findings with important implications for treatment at the 2015 European Cancer Congress.

“Dr M. Catherine Pietanza, MD, an Assistant Attending Physician at the Memorial Sloan Kettering Cancer Center, New York, USA, will report on results from a phase I trial of a novel agent, rovalpituzumab tesirine (Rova-T, or S16LD6.5), in 79 patients with SCLC who had progressed after first line (given when the disease is newly diagnosed) or second line therapy (given when the disease progresses or recurs).

” ‘While other cancers have multiple treatment options, there is only one agent approved in SCLC, and none available in the third line setting; the outlook for these patients is dismal,’ she will say. Third line therapy is given after first and second line treatments have failed to halt the progression of disease.”


OncoMed Pharmaceuticals Announces Presentation of Tarextumab Small Cell Lung Cancer Data at the 16th World Conference on Lung Cancer

“OncoMed Pharmaceuticals Inc. (NASDAQ: OMED), a clinical-stage company developing novel anti-cancer stem cell and immuno-oncology therapeutics, reported new biomarker and updated clinical data for the company’s Phase 2 anti-Notch2/3 therapeutic candidate, tarextumab (OMP-59R5). These data show the potential of Notch3 overexpression as a prognostic factor in small cell lung cancer and update OncoMed’s Phase 1b results for tarextumab in combination with standard-of-care chemotherapy for the first-line treatment of patients with extensive-stage disease. Anne Chiang, M.D., Ph.D., of the Yale School of Medicine, will present these data in a mini-oral presentation this afternoon at the 16th World Lung Conference on Lung Cancer.

” ‘Notch is known to be a fundamental cancer stem cell pathway driving the initiation and spread of tumors. Notch3 in particular has been associated with poor prognosis in a variety of solid tumor types, including pancreatic, breast and ovarian cancers,’ said Dr. Chiang. ‘Our analyses of small cell lung cancer patient tumors demonstrate that Notch3 overexpression in extensive-stage small cell lung cancer tumors is common and may be associated with poor survival. This is the first time that Notch3 tumor expression has been tested in small cell lung cancer and associated with poor patient outcomes.’ “


Super Advocate: Laura Gheorghiu Seeks Better Care for Her Mom—and for Cancer Patients Across Canada


Laura Gheorghiu’s mother didn’t usually go to the doctor for just a cold. After she moved to Québec four years ago, it took a long time to get a family doctor through the public healthcare system and, until then, seeing one meant sitting for hours in a walk-in clinic. But she did seek care for a cold late last fall. For one thing, she finally had a doctor. For another, she had a really bad cold. Continue reading…


Lung NETs and Their Treatment


Cancers that arise in the lung are mostly of the type known as NSCLC (non-small cell lung carcinoma). A much smaller proportion of lung tumors arise from neuroendocrine cells in the lungs. These cells (which are also found in most other organs) secrete a variety of hormones that are necessary for normal organ function, as well as for healing after injury or infection. Like other lung cells, neuroendocrine cells may transform to become cancers. Lung cancers that arise from neuroendocrine cells are called pulmonary neuroendocrine tumors (NETs), or lung NETs. Continue reading…