Goals of Therapy and Considerations for Treatment Sequencing in Extensive Stage Small Cell Lung Cancer

Opinion
Video

Ticiana Leal, MD, discusses how in cases of extensive stage small cell lung cancer (ES-SCLC) that progress within 6 months of platinum-based chemotherapy, treatment options such as tarlatamab, lurbinectedin, topotecan, and irinotecan should be considered, alongside the potential to extend chemoimmunotherapy cycles. She also addresses the impact of National Comprehensive Cancer Network (NCCN) guidelines and the consideration of prophylactic cranial irradiation (PCI) despite negative brain imaging results.

Video content above is prompted by the following:

  1. In the case of ES-SCLC that progresses in less than 6 months after a second course of platinum-based chemotherapy, what other treatment options, in the absence of a clinical trial, would you consider as a subsequent line of therapy, and why?
  2. Would you alter your treatment sequencing for a similar case of ES-SCLC that had progressed after a CTFI longer than 6 months?
  3. How do the current NCCN clinical practice guidelines (V3.2024) inform your choice of preferred regimens?
  4. Despite negative results from serial brain MRI, would you consider PCI in this patient and why or why not?
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