SCLC staging and treatment

• SCLC usually disseminated at presentation; poor overall survival
• Can be very responsive to chemotherapy, but rapidly develop resistance
• Diagnosis: all have Rb & p53 mutations (Nature 2015;524:47); 90% w/ neuroendo markers
• Treatment: primarily chemo (platinum + etoposide); adding anti-PD-L1 Ab atezolizumab ↑ survival (NEJM 2018;379:2220), as does concurrent thoracic RT in limited-stage disease
• Prophylactic cranial irradiation (PCI) controversial. Offered to potentially ↑ survival for LS-SCLC in complete remission (NEJM 1999;341:476). Role in ES-SCLC being studied.
• Second line: low response rates, short survival. Options: lurbinectedin, single-agent chemo (eg, topotecan, docetaxel), reRx w/ platinum doublet, anti-PD-1 (eg, nivo).

Explain by ChatGPT

• SCLC staging and treatment:
  • SCLC usually disseminated at presentation; poor overall survival
  • Can be very responsive to chemotherapy, but rapidly develop resistance
  • Diagnosis: all have Rb & p53 mutations; 90% w/ neuroendo markers
  • Treatment: primarily chemo (platinum + etoposide); adding anti-PD-L1 Ab atezolizumab ↑ survival, as does concurrent thoracic RT in limited-stage disease
  • Prophylactic cranial irradiation (PCI) controversial. Offered to potentially ↑ survival for LS-SCLC in complete remission. Role in ES-SCLC being studied.
  • Second line: low response rates, short survival. Options: lurbinectedin, single-agent chemo (eg, topotecan, docetaxel), reRx w/ platinum doublet, anti-PD-1 (eg, nivo).

窩的英文不太好，只好請估🐶

• SCLC 分期和治療：
  • SCLC 通常在介紹時傳播； 總體生存率低
  • 對化療非常敏感，但會迅速產生耐藥性
  • 診斷：均有Rb & p53突變； 90% w/ neuroendo 標記
  • 治療：主要是化療（鉑 + 依托泊苷）；添加抗 PD-L1 抗體 atezolizumab ↑ 生存期，與局限期疾病的同步胸部放療一樣
  • 預防性顱腦照射（PCI）有爭議。提供 LS-SCLC 完全緩解的潛在 ↑ 生存。在 ES-SCLC 中的作用正在研究中。
  • 二線：反應率低，生存期短。選項：lurbinectedin、單藥化療（例如托泊替康、多西紫杉醇）、reRx w/鉑雙藥、抗 PD-1（例如 nivo）。