Oncology Brothers: Practice-Changing Cancer Discussions How to treat Small Cell Lung Cancer in 2025
May 19, 2025
Dr. Ticiana Leal, a thoracic medical oncologist at the Winship Cancer Institute of Emory University, shares insights on small cell lung cancer treatment. She discusses recent breakthroughs like durvalumab approvals and immunotherapy options, emphasizing the importance of clinical trials. The conversation dives into the effectiveness of growth factors, yet points out their underutilization. Innovations in treatment methods, including the potential of novel therapies like Tarlatamab, are also highlighted, showcasing the dynamic future of lung cancer care.
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Limited Stage Treatment Options
- For limited stage small cell lung cancer with resectable, node-negative tumors under 5 cm, surgery followed by platinum chemotherapy is the recommended approach.
- If patients are not surgical candidates, SBRT or concurrent chemoradiation with platinum-etoposide and consolidation immunotherapy is advised.
PCI Discussion in Limited Stage
- Discuss prophylactic cranial irradiation (PCI) with limited stage small cell lung cancer patients as it may improve survival.
- Consider MRI surveillance instead of PCI in patients with cognitive concerns or contraindications.
Carboplatin Use Preferred Over Cisplatin
- Carboplatin may be preferred over cisplatin in limited stage SCLC to reduce toxicity and help patients reach consolidation immunotherapy.
- Adriatic trial data suggests carboplatin patients did better, supporting this approach.