Choice of second-line systemic therapy in stage IV small cell lung cancer (SCLC) - A decision-making analysis amongst European lung cancer experts - Publication

Publication

Choice of second-line systemic therapy in stage IV small cell lung cancer (SCLC) - A decision-making analysis amongst European lung cancer experts

Journal Paper/Review - Mar 30, 2020

Früh Martin, De Ruysscher D, Westeel V, de Marinis F, Paz Ares L, O'Brien M, Felip E, Garrido P, Novello S, Besse B, Cappuzzo F, Califano R, Blackhall F, Reck M, Panje C M, Putora Paul Martin

Citation

Früh M, De Ruysscher D, Westeel V, de Marinis F, Paz Ares L, O'Brien M, Felip E, Garrido P, Novello S, Besse B, Cappuzzo F, Califano R, Blackhall F, Reck M, Panje C, Putora P. Choice of second-line systemic therapy in stage IV small cell lung cancer (SCLC) - A decision-making analysis amongst European lung cancer experts. Lung Cancer 2020; 146:6-11.

Type

Journal Paper/Review (English)

Journal

Lung Cancer 2020; 146

Publication Date

Mar 30, 2020

Issn Electronic

1872-8332

Pages

6-11

Brief description/objective

OBJECTIVES
Stage IV small cell lung cancer (SCLC) is associated with short survival and progression after first-line systemic therapy frequently occurs within months. Although topotecan is approved for second-line treatment, its efficacy is limited, and treatment heterogeneity exists.

MATERIAL AND METHODS
The decision-making patterns for second line treatment of 13 European medical oncologists with expertise in SCLC were analyzed.

RESULTS
The two criteria most relevant to decision-making were the performance status and the interval of recurrence since first-line treatment. With an interval of less than 3 months since the end of first-line chemotherapy, 62 % of the experts recommended cyclophosphamide, doxorubicin and vincristine (CAV) for fit patients and 54 % recommended topotecan for unfit patients. For an interval of more than 6 months, a clear consensus for a re-challenge with a platinum doublet was achieved (92 %). However, there was no consensus on the second-line therapy with an interval of 3-6 months since the end of first-line therapy.

CONCLUSION
Real world practice may differ from recommendations in general guidelines and cannot always be directly derived from trial results as other factor such as habits, patient's preference, convenience or costs have to be factored in.