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Chemo Combo Increases Survival, Toxicity in Sensitive Relapsed SCLC

Chemo Combo Increases Survival, Toxicity in Sensitive Relapsed SCLC | Lung Cancer Dispatch | Scoop.it

"Cisplatin, etoposide, and irinotecan outperformed topotecan as second-line chemotherapy in patients with sensitive relapsed small-cell lung cancer (SCLC) in a Japanese trial, though there was substantially increased toxicity with the regimen.


“ 'Topotecan is the only drug approved in the United States and the European Union for relapsed SCLC,' said Koichi Goto, MD, PhD, of the National Cancer Center Hospital East in Chiba, Japan. He presented results of the new trial at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. Sensitive relapse refers to cancers that respond to initial chemotherapy and relapse more than 3 months after completion of that therapy, while refractory cancers do not respond initially or relapse within that 3 month window."


Editor's note: This story is about a clinical trial with volunteer patients to test a new treatment for small cell lung cancer (SCLC). The new treatment is specifically for people with SCLC who were treated with chemotherapy successfully, but whose cancer returned more than 3 months after chemo—this is known as "sensitive relapsed SCLC." The new treatment combines three chemo drugs: cisplatin, etoposide, and irinotecan. In the clinical trial, some patients took the chemo combo and some were treated with the chemo drug topotecan, which is a standard treatment for the condition. Patients who took the new treatment lived longer, but they had more toxic side effects than the patients who took topotecan.

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Cancer Network  |  Jun 23, 2014

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'Liquid Biopsy' Offers New Way to Track Lung Cancer

'Liquid Biopsy' Offers New Way to Track Lung Cancer | Lung Cancer Dispatch | Scoop.it

"Scientists have shown how a lung cancer patient's blood sample could be used to monitor and predict their response to treatment – paving the way for personalised medicine for the disease.


"The recent study, published in the journalNature Medicine, also offers a method to test new therapies in the lab and to better understand how tumours become resistant to drugs.


"Small cell lung cancer (SCLC) is an aggressive disease with poor survival and new treatments are desperately needed. In many cases the tumour is inoperable and biopsies are difficult to obtain, giving scientists few samples with which to study the disease."

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Medical Xpress  |  Jun 3, 2014

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ELCC 2014 News: Cabazitaxel Fails to Meet the Primary Endpoint in a Randomised Phase II Study in SCLC Patients

ELCC 2014 News: Cabazitaxel Fails to Meet the Primary Endpoint in a Randomised Phase II Study in SCLC Patients | Lung Cancer Dispatch | Scoop.it

"Cabazitaxel failed to meet a primary endpoint of showing superior progression-free survival (PFS) and additionally showed less favourable median overall survival (OS) compared to topotecan in an international, randomised open-label phase II trial performed in patients with small-cell lung cancer (SCLC), who had progressed during or after first-line platinum-based chemotherapy. The results were presented by Dr Tracey Evans of the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, USA in a proffered papers session at the 4th European Lung Cancer Conference (26-29 March 2014, Geneva, Switzerland)."


Editor's note: This trial found disappointing results for the drug cabazitaxel in treating small cell lung cancer (SCLC). To read about promising SCLC treatments, see this blog feature.

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ESMO  |  Mar 28, 2014

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IMGN901 Demonstrates No Significant Benefit, Possible Harm in Small Cell Lung Cancer

IMGN901 Demonstrates No Significant Benefit, Possible Harm in Small Cell Lung Cancer | Lung Cancer Dispatch | Scoop.it

The makers of lorvotuzumab mertansine (IMGN901) have halted a clinical trial investigating the use of the drug in extensive-stage small-cell lung cancer (SCLC). An independent monitoring group recommended ending the trial because patients treated with IMGN901 in addition to the chemotherapy agents etoposide (Etopophos) and carboplatin (Paraplatin) fared no better than patients treated with Etopophos and Paraplatin only. Furthermore, the patient group receiving IMGN901 appeared to have higher rates of infections and infection-related deaths, with at least one death potentially related to IMGN901.

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Antidepressant Drugs May Also Treat SCLC

Antidepressant Drugs May Also Treat SCLC | Lung Cancer Dispatch | Scoop.it

Two drugs that are currently approved to treat symptoms of depression may also be effective against small cell lung cancer (SCLC). Researchers used bioinformatics, which combines mathematics and computer science to analyze large amounts of biological data, to pinpoint drugs likely to act on pathways that are important in SCLC. They identified the antidepressant imipramine (Tofranil) and the sedative/anti-nausea medication promethazine (Phenergan). Both drugs killed SCLC cells both in cell culture and in mouse models of chemotherapy-resistant SCLC. SCLC tumors arise from cells that are part of the hormone and nervous system, which may explain the effectiveness of these drugs. A new clinical trial will explore the effectiveness of desipramine (Norpramin), a drug similar to Tofranil, in SCLC.

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ScienceDaily | Sep 27, 2013

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RNA Diagnostic Test Improves Diagnosis of Lung Cancer

RNA Diagnostic Test Improves Diagnosis of Lung Cancer | Lung Cancer Dispatch | Scoop.it

The first step towards choosing the best lung cancer treatment is to figure out what specific kind of lung cancer a patient has. Usually, doctors can determine cancer type by surgically removing part of a tumor and examining the appearance of tumor cells under a microscope. But sometimes tumor samples are damaged and difficult to analyze visually, so a second method would be useful to help confirm a diagnosis. Researchers have now developed a new test that can determine which genes are turned on or off in tumor cells, allowing them to distinguish between the most common types of lung cancer (adenocarcinoma, carcinoid, small cell carcinoma, squamous cell carcinoma). Samples of tumors are already routinely collected, and, in an experiment, examining them and analyzing their genetics was found to be a viable predictor of a tumor’s microscopic appearance. Researchers hope that their test will bring more accurate diagnoses to doctors and patients, which in turn could lead to better treatment recommendations and better outcomes.

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Medical Xpress | Jul 16, 2013

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Sutent May Hold Off Relapse in SCLC

Small cell lung cancer (SCLC) usually responds well to initial chemotherapy, but frequently relapses within a short time. Maintenance therapy with the drug sunitinib (Sutent) may delay relapse and improve outcomes for SCLC patients, results from a recent phase II clinical trial suggest. Patients with extensive-stage SCLC who had responded to initial chemotherapy were given either Sutent as maintenance therapy or a placebo. Sutent, a tyrosine kinase inhibitor (TKI) that blocks several proteins involved in SCLC, prolonged the time without cancer progression (3.2 months on average, compared to 2.3 months in the placebo-treated patients). Patients receiving Sutent also tended to have longer overall survival (8.9 months vs 6.9 months with placebo), although this finding was not clear enough to determine whether it was due to chance. The survival difference between patient groups may have been smaller because placebo-treated patients whose cancer relapsed were allowed to switch to Sutent, suggesting that Sutent may actually have more definite effects on patient survival.

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MedPage Today | June 5, 2013

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Engaging the Immune System May Be a Useful Strategy in SCLC

Drugs that enhance the body’s immune response (immunotherapies) may help patients with small cell lung cancer (SCLC). Immunotherapy may be beneficial on its own, but could also complement standard chemotherapy. An overview of recent studies and ongoing clinical trials highlighted several promising immunotherapies, including ipilimumab (Yervoy). Yervoy, which has been approved to treat certain kinds of skin cancer, targets a protein called CTLA4, which acts as an "off switch" on immune system cells. By deactivating CTLA4, Yervoy allows the immune system to continue attacking tumors. Another immune treatment that may be combined with traditional chemotherapy is interferon-alpha, a molecule that stimulates the body’s immune cells.

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Journal of Thoracic Oncology | Apr 15, 2013

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Small Cell Lung Cancer Patient Treated for 5 Years with Chemotherapy and Lower Airway Clearing

Small cell lung cancer (SCLC) often extends to the bronchi (airway branches that connect the windpipe to the lungs), leading to breathing difficulties. A patient with extensive-stage SCLC received "endobronchial management," in which electrical currents were used to burn off tumor growth and keep the airway clear. He also received standard chemotherapy with cisplatin (Platinol). The patient remained in good condition for 5 years, after which he developed symptoms from cancer spread to the brain and eventually passed away. Adding endobronchial management to chemotherapy may increase survival in SCLC patients, although caution should be used in drawing conclusions from a single case study.

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Pneumologia | Feb 21, 2013

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Renewed Radiation Therapy Benefits Some Patients with Recurrent Lung Cancer

About one-third of lung cancer patients treated with radiation therapy and chemotherapy experience recurrence at or near the original site. A study of patients with non-small cell lung cancer (NSCLC) or small-cell lung cancer (SCLC) investigated the use of renewed radiation ("reirradiation" or reRT) for such "locoregional recurrence." ReRT relieved symptoms in 75% of NSCLC patients and conferred long-term survival in some, especially those who had little functional impairment at the time of treatment and had received higher doses of radiation. Some SCLC patients whose returning cancer was small and did not cause symptoms, and whose cancer had not spread outside the chest region, also experienced increased survival from reRT. For all other SCLC patients, reRT produced no meaningful benefits.


Research paper: http://graphics.tx.ovid.com/ovftpdfs/FPDDNCMCHELLGK00/fs047/ovft/live/gv024/00000421/00000421-900000000-99449.pdf

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American Journal of Clinical Oncology | Jan 24, 2013

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Clinical Trial Will Examine Effectiveness of CRLX101 for Small Cell Lung Cancer

Clinical Trial Will Examine Effectiveness of CRLX101 for Small Cell Lung Cancer | Lung Cancer Dispatch | Scoop.it

Cerulean Pharma Inc. is beginning a phase II clinical trial that will investigate the safety and effectiveness of a novel chemotherapy drug, CRLX101, in patients with extensive-stage small cell lung cancer (SCLC) who have responded to first-line, platinum-based chemotherapy. The study will compare CRLX101 to topotecan (Hycamtin), which is currently the only approved second-line therapy for relapsed SCLC. CRLX101 is already being assessed as a treatment for non-small cell lung cancer (NSCLC) in another phase II trial close to completion, and may be safer than Hycamtin.

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News-Medical.Net | Jan 31, 2013

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Thoracic RT Yields Improved Survival in Extensive-Stage SCLC

Thoracic RT Yields Improved Survival in Extensive-Stage SCLC | Lung Cancer Dispatch | Scoop.it

"Thoracic radiotherapy along with prophylactic cranial irradiation (PCI) significantly prolonged progression-free and overall survival in patients with extensive-stage small-cell lung cancer, according to results of a new study presented at ASCO.


"Ben Slotman, MD, PhD, of VU University Medical Center in Amsterdam, presented the study and said that previous work had shown that PCI could improve both symptomatic brain metastases and overall survival at 1 year. 'In that study, we also noticed that the vast majority of patients after chemotherapy had intrathoracic disease' and intrathoracic progression, he said, which was the impetus for the new study using thoracic radiotherapy."


Editor's note: To learn more about new prospects for treating small cell lung cancer (SCLC), see our two-part blog feature on the topic.

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Cancer Network  |  Jun 5, 2014

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Amrubicin and Cisplatin Inferior to Irinotecan Regimen for Small-Cell Lung Cancer

Amrubicin and Cisplatin Inferior to Irinotecan Regimen for Small-Cell Lung Cancer | Lung Cancer Dispatch | Scoop.it

"A combination of amrubicin and cisplatin was inferior to irinotecan and cisplatin in chemotherapy-naïve patients with extensive disease small-cell lung cancer (SCLC) in a phase III trial conducted in Japan. The irinotecan regimen remains the standard treatment for these patients in that country.


"SCLC accounts for 13% of all new cases of lung cancer, and more than half of those patients present with extensive disease. Though SCLC can be very sensitive to chemotherapy, authors of the new study wrote that “rapid emergence of clinical drug resistance has resulted in poor prognosis, with almost all such patients dead with 2 years of initial diagnosis.” Investigators led by Miyako Satouchi, MD, PhD, of the Hyogo Cancer Center in Akashi, Japan, tested the amrubicin and cisplatin combination against irinotecan and cisplatin in 284 patients; results were published online ahead of print on March 17 in the Journal of Clinical Oncology."

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Cancer Network  |  Apr 23, 2014

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New Clinical Trial for SCLC Now Enrolling Patients

New Clinical Trial for SCLC Now Enrolling Patients | Lung Cancer Dispatch | Scoop.it

While medical research has produced significant treatment innovations for many cancer types, so far little has changed for small cell lung cancer (SCLC). Current treatment guidelines recommend chemotherapy with etoposide (Etopophos) and cisplatin (Platinol), drugs than are more than 30 years old. Relapse is common, and survival rates remain low. Now, the new  PINNACLE clinical trial will investigate a new drug against SCLC. Patients with extensive-stage SCLC who have never received any other cancer treatment will be treated with Etopophos and Platinol either by themselves or in combination with the new drug, OMP-59R5. The drug acts by inhibiting NOTCH, a protein involved in cell development and growth that plays a role in various cancers. For more information, call 646-888-4203.

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ScienceDaily | Nov 13, 2013

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Chemotherapy Associated with Longer Survival in Elderly Patients with SCLC

Chemotherapy Associated with Longer Survival in Elderly Patients with SCLC | Lung Cancer Dispatch | Scoop.it

Although it is generally accepted that chemotherapy can benefit patients with small cell lung cancer (SCLC), the value of chemotherapy in elderly patients compared to other treatment options is less well-known. A retrospective study analyzing over 10,000 medical records of SCLC patients aged 65 years or older found that those who had received chemotherapy survived on average 6.5 months longer. However, only around two-thirds of elderly patients had been treated with chemotherapy. Older patients were less likely to be given chemotherapy, even though the survival benefits of chemotherapy were seen even in patients over the age of 80 years. Other treatments, such as radiation or surgery, were also linked to longer survival.

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Healio | Oct 1, 2013

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Chemotherapy Improves Survival in Elderly Patients with SCLC

Chemotherapy Improves Survival in Elderly Patients with SCLC | Lung Cancer Dispatch | Scoop.it

A recent retrospective study of outcomes in elderly patients with small cell lung cancer (SCLC) found that chemotherapy treatment was associated with longer survival. Patients aged 65 years and older who had received chemotherapy lived, on average, 6.5 months longer than those who had not. Even in patients over age 80 years, chemotherapy provided a survival benefit. Despite this, one-third of elderly SCLC patients were never given chemotherapy, and one-sixth were never even referred to a medical oncologist (cancer specialist). These findings suggest that chemotherapy is an effective treatment for SCLC in elderly patients and should be more widely used in this population.

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ScienceDaily | Sep 4, 2013

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Evaluating Small Cell Lung Cancer with PET-CT Scans Improves Survival

Evaluating Small Cell Lung Cancer with PET-CT Scans Improves Survival | Lung Cancer Dispatch | Scoop.it

Accurately 'staging' small cell lung cancer (SCLC), that is, determining its extent and spread in a patient, is crucial in choosing treatment. One year after treatment guidelines began recommending positron emission tomography - computed tomography (PET-CT) instead of bone scans for the initial evaluation of all newly diagnosed SCLC patients, researchers confirmed that the new staging method improved outcomes. A study of SCLC patients diagnosed with limited-stage disease (ie, cancer that is confined to only one lung or its immediately surrounding tissue) showed that those who had received PET-CT staging before their treatment had higher 3-year survival rates (47% vs 19%) than those who did not.

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Medical Xpress | Jun 25, 2013

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Clinical Trial Reveals Patients' Willingness to Undergo Genetic Testing for Personalized Cancer Treatment

Clinical Trial Reveals Patients' Willingness to Undergo Genetic Testing for Personalized Cancer Treatment | Lung Cancer Dispatch | Scoop.it

A recently completed clinical trial examining the use of genetic testing to direct cancer treatment was able to exceed its enrollment goal of 600 participants in less than 2 years instead of the expected 5 years. Patients were willing to participate even though they had to undergo an additional biopsy, revealing considerable interest in personalized treatment based on genetic tests. The trial confirmed that erlotinib (Tarceva) is highly effective in non-small cell lung cancer (NSCLC) patients with a mutation in the EGFR gene. It also found that NSCLC patients with mutations in the KRAS gene did not benefit from the novel cancer drug selumetinib. In contrast, not enough small cell lung cancer (SCLC) patients had any of the investigated mutations to properly test how they responded to treatments. Such mutations will require trials involving thousands of patients to draw reliable conclusions.

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ScienceDaily | May 15, 2013

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ScienceDaily | May 15, 2013

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ScienceDaily | May 15, 2013

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Clinical Trial of New SCLC Drug Enrolling Patients

Clinical Trial of New SCLC Drug Enrolling Patients | Lung Cancer Dispatch | Scoop.it

A clinical trial at six study sites, including Smilow Cancer Hospital at Yale-New Haven, will investigate a new treatment for small cell lung cancer (SCLC). IMGN901 (lorvotuzumab mertansine), produced by ImmunoGen, is a novel type of treatment that targets CD56, a protein that is expressed by tumors in a number of different cancers, including SCLC. Because IMGN901 specifically targets a tumor protein, the toxic drug is delivered preferentially to cancer cells and is less likely to harm healthy cells. Another drug using a similar mechanism was recently approved for breast cancer.


To find out more about the trial, call 203-200-5864.

ImmunoGen page on IMGN901: http://www.immunogen.com/pipeline/lorvotuzumab-mertansine/

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New Haven Register | Mar 2, 2013

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Systemic Chemotherapy Is Effective in Small Cell Lung Cancer with Brain Metastases

Between one-tenth and one-fourth of patients with small cell lung cancer (SCLC) have brain metastases (cancer that has spread to the brain) when they are first diagnosed; up to half will develop them at some point during the course of their disease. There have not been many studies on the use of systemic chemotherapy (ie, chemotherapy in which drugs are allowed to circulate throughout the body) in these patients, but research suggests that it is an effective first- or second-line treatment. Systemic chemotherapy is especially recommended for SCLC patients with brain metastases who do not yet show symptoms.

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Bulletin du Cancer | Jan 1, 2013

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Pomalidomide Can Be Safely Added to Chemotherapy in Small Cell Lung Cancer

In a recent phase I/IIa study, patients with extensive-stage small cell lung cancer (SCLC) that had not previously been treated were given a drug called pomalidomide. The treatment was combined with standard chemotherapy consisting of cisplatin (Platinol) and etoposide (Etopophos/Toposar). Pomalidomide appeared to be safe, with a maximum tolerated dose of 4 mg/day. However, it did not appear to increase the efficacy or decrease the toxicity of the chemotherapy.

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Journal of Thoracic Oncology | Jan 30, 2013

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Pilot Study of New SCLC Drug Offers Encouragement

Preliminary trial results indicate that a new drug, IMGN901, enhances standard etoposide/carboplatin treatment in some small cell lung cancer (SCLC) patients. IMGN901 targets cells that express the protein CD56—a hallmark of nearly all SCLC tumors. ImmunoGen, Inc. will further investigate the SCLC treatment potential of IMGN901 in the large-scale NORTH trial.

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