Does Small-Cell Lung Cancer (SCLC) Respond to Chemotherapy?
Up to 80% of limited stage SCLC cases respond to chemotherapy. Extensive stage SCLC is usually treated with a combination of chemotherapy and immunotherapy and has a response rate of more than 60%.
Small-cell lung cancer (SCLC) tends to be more aggressive and more difficult to treat than the other main type of lung cancer, non-small cell lung cancer (NSCLC). The 5-year relative survival rate for SCLC is 7% , while that rate is 28% for NSCLC.
Chemotherapy is one of six standard treatments used for SCLC. Doctors can use chemotherapy to cure SCLC if the cancer is diagnosed in the early stages. Late stage SCLC isn’t usually considered curable, but chemotherapy can help prolong your life and reduce your symptoms.
Read on to learn more about how chemotherapy is used to manage SCLC and about SCLC’s response rates to chemotherapy.
Chemotherapy plays a critical role in treating SCLC and NSCLC. Chemotherapy drugs target cells that replicate quickly, such as cancer cells. These drugs damage the DNA of cancer cells to destroy them or slow their growth.
Chemotherapy is used to treat all stages of SCLC, but the goal of treatment changes depending on how advanced your cancer is.
Most doctors divide SCLC into two categories: limited stage and extensive stage.
Limited stage SCLC
In limited stage SCLC, the cancer is contained to one side of your chest and can be treated with a single field of radiation. It may have reached lymph nodes on the same side as your affected lung.
A combination of chemotherapy drugs is often administered together with radiation therapy in people with limited stage SCLC to try to cure the cancer. Your healthcare team may use chemotherapy alone if you cannot undergo radiation therapy.
You may have surgery to remove the tumor or lymph nodes before receiving chemotherapy.
Limited stage SCLC is highly sensitive to chemotherapy — it responds to chemotherapy treatment 60% to 80% of the time. However, SCLC tumors often return or spread to distant areas. Half of people treated with platinum chemotherapy drugs and etoposide live at least 25 to 30 months , and 30% to 35% of people live at least 5 years.
Trying the same chemotherapy regimen again is recommended for relapses that occur more than 6 months after the initial therapy. If your relapse occurs within 6 months of your treatment, it’s generally recommended to try a different regimen with a single chemotherapy drug.
Extensive stage SCLC
In extensive stage SCLC, the cancer has spread:
- throughout your lung
- to the other lung
- to lymph nodes on the other side of your chest
- to distant body parts such as bone marrow
More than 70% of people with SCLC have extensive stage disease when they receive their diagnosis.
Extensive stage SCLC is most commonly treated with a combination of chemotherapy and immunotherapy.
The response rate of platinum-based chemotherapy plus etoposide is more than 60% , and a complete response occurs in about 10% of people. However, as with limited stage disease, relapse is common. About half of people live less than 8 to 10 months .
Most common chemotherapy combinations for SCLC
Doctors usually treat SCLC with a combination of chemotherapy drugs. According to the American Cancer Society , the most common combinations are:
- cisplatin and etoposide
- carboplatin and etoposide
- cisplatin and irinotecan
- carboplatin and irinotecan
Topotecan or lurbinectedin may be used alone to treat SCLC that has spread to other organs, especially if cisplatin and carboplatin are not effective.