Long-term survival remains a challenge in small cell lung cancer

HOLLYWOOD, Fla. – Survival trends in small cell lung cancer patients were found to be discouraging with only some marginal increase in the more than two-year survival rate and a slight change over the last 30 years in five-year survival, according to Gregory P. Kalemkerian, MD.

Kalemkerian, professor of medicine and co-director of thoracic oncology at the University of Michigan, presented information on new advancements made in the area of small cell lung cancer at the NCCN 13th Annual Conference: Clinical Practice Guidelines and Quality Cancer Care.

“We need to do a somewhat better job in the academic setting and in the community setting in trying to find new modalities that will hopefully benefit small cell lung cancer patients in the future,” Kalemkerian said.

When researchers reviewed large community databases, overall five-year survival was found to be about 5% and has not changed significantly in the last 30 years, Kalemkerian said. However, findings from the Surveillance Epidemiology and End Results database have shown a decrease from 20% to 17% in the number of lung cancers that are small cell lung cancer.

Because of the aggressiveness and the location of small cell lung cancer, the benefit of screening technologies is questionable. “Empiric chemotherapy, I think, is unlikely to add further benefits with regard to survival. We need to further identify molecular targets and continue to test molecular targets that affect survival, proliferation and metastatic spread, with metastatic spread being the major problem in small cell lung cancer,” Kalemkerian said.

He and his colleages are exploring the pathways involved with stem cells. They have been able to characterize and identify the lung cancer progenitor as stem cells, which could be the source of the problem in small cell lung cancer, Kalemkerian said. Researchers have also seen dramatic responses clearing the more mature component, though there is a residual resisting component left behind.

“We also need to enroll patients into rational clinical trials—something that has unfortunately decreased over the last few years in small cell lung cancer,” Kalemkerian said. – by Paul Burress

For more information:

Kalemkerian GP. New advances in small cell lung cancer. Presented at: NCCN 13th Annual Conference; March 5-9, 2008; Hollywood, Fla.