Strategies to Improve Treatment of Recurrent Small Cell Lung Cancer

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

Researchers are currently investigating new treatments for recurrent small cell lung cancer. Participation in trials of these treatments will lead to improved therapies. If you wish to participate in a clinical trial, please talk to your doctor about the potential benefits and side effects of the treatment.

• Clinical trials - New anti-cancer therapies continue to be developed and evaluated in clinical trials. The purpose of these trials is to evaluate new drugs in order to determine the best way of administering the drug and whether the drug has any anti-cancer activity in patients with lung cell cancer.
• New chemotherapy regimens - Development of new multi-drug chemotherapy treatment regimens that incorporate new or additional anti-cancer therapies for use as treatment is an active area of clinical research carried out in phase II clinical trials.
• Biologic therapy - Following cancer treatment with chemotherapy, patients often achieve a complete remission (disappearance of the cancer). Unfortunately, many patients in remission will later experience a relapse of their cancer. This is because not all of the cancer cells were destroyed. Doctors refer to this as a state of "minimal residual disease". Many doctors believe that applying additional cancer treatments when only a few cancer cells remain represents the best opportunity to prevent the cancer from returning. Biologic agents that stimulate the immune system are being evaluated to prevent or delay relapses. Examples of biologic agents that can be used to treat minimal residual cancer include cytokines, vaccines and monoclonal antibodies. Large multi-institutional and several smaller clinical trials are ongoing to evaluate these new approaches.
• Gene therapy - Currently, there are no gene therapies approved for the treatment of lung cancer. Gene therapy is defined as the transfer of new genetic material into a cell for therapeutic benefit. This can be accomplished by replacing or inactivating a dysfunctional gene or replacing or adding a functional gene into a cell to make it function normally. Gene therapy has been directed towards the control of rapid growth of cancer cells, control of cancer death or efforts to make the immune system kill cancer cells. A few gene therapy studies are being carried out in patients with lung cancer. If successful, these therapies could be applied to patients with earlier stage disease.
• Supportive care - Supportive care refers to treatments designed to prevent and control the side effects of cancer and its treatment. Side effects not only cause patients discomfort, but also may prevent the optimal delivery of therapy at its planned dose and schedule. In order to achieve optimal outcomes from treatment and improve quality of life, it is imperative that side effects resulting from cancer and its treatment are appropriately managed.
• Photodynamic therapy - Photodynamic treatment is now in clinical trials for patients with recurrent SCLC whose cancer is causing endobronchial obstruction. Photodynamic therapy works through the use of a photosensitizing agent and light. The photosensitizing agent is typically comprised of a porphyrin, which is a naturally occurring substance in the body involved in a variety of biological processes. The photosensitizing agent is injected into a patient’s vein a couple of hours prior to surgery. During this time, the agent selectively collects in rapidly growing cells such as cancer cells. During surgery, the physician applies a certain wavelength of light through a hand held wand directly to the site of the cancer and surrounding tissues. The energy from the light activates the photosensitizing agent, causing the production of a toxin that accumulates in the cancer cells and ultimately destroys them.