SMALL-CELL LUNG-CANCER - IS THERE A STANDARD THERAPY

For more than 25 years, chemotherapy has been the cornerstone of treat ment for small-cell lung cancer. Many studies have tested a wide varie ty of drugs in different combinations, resulting in a number of standa rd combination chemotherapy options. Radiotherapy to the primary tremo r, after having been out of favor for a time, is now considered an ele ment of standard therapy for patients with limited disease, although a number of questions remain concerning its optimal use. Because the ov erall outcome of therapy for small-cell lung cancer is not at all sati sfying, further research is needed to find a better use of old and new drugs. This article provides a historic overview of therapy for small -cell lung cancer, followed by examples of emerging concepts and curre nt research in such areas as dose escalation, second-line therapy, and new drugs. Selection of optimal first-line therapy for the individual patient Is also discussed, based on disease stage, performance status , and other considerations.