Selecting Treatment for Late-Stage SCLC

Afshin Dowlati, MD, Lucile and Robert H Gries Endowed director, Center for Cancer Drug Development, University Hospitals, director Thoracic Oncology Program, UH Seidman Cancer Center, and professor, Department of Medicine Division of Hematology and Oncology, School of Medicine, discusses treatment decision-making for patients with late-stage small cell lung cancer (SCLC).

Multiple factors should be considered when selecting treatment for patients with late-stage SCLC, says Dowlati. The most important factor is their performance status, but whether or not the patient can tolerate chemotherapy and a combination regimen is also key.

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0:08 | Probably the most important factor in deciding treatment is really the performance status of the patient. We know that patients with small cell lung cancer even when they have a very poor performance, that combination chemotherapy can be effective in them as well. And many of them will have an improved performance status within 1 cycle of chemotherapy.

0:30 | It is not uncommon for patients to be admitted for their first cycle of chemotherapy and in that case, I give the chemotherapy alone and add the immunotherapy checkpoint inhibitors such as durvalumab [Imfinzi] with cycle number 2. For those that are fit and are in good performance status, I tend to use the addition of durvalumab with the chemotherapy upfront starting from cycle number 1.