SEOM-GECP Clinical guidelines for diagnosis, treatment and follow-up of small-cell lung cancer (SCLC) (2022)

Small-cell lung cancer (SCLC) is a highly aggressive malignancy comprising approximately 15% of lung cancers. Only one-third of patients are diagnosed at limited-stage (LS). Surgical resection can be curative in early stages, followed by platinum-etoposide adjuvant therapy, although only a minority of patients with SCLC qualify for surgery. Concurrent chemo-radiotherapy is the standard of care for LS-SCLC that is not surgically resectable, followed by prophylactic cranial irradiation (PCI) for patients without progression. For extensive-stage (ES)-SCLC, a combination of platinum and etoposide has historically been a mainstay of treatment. Recently, the efficacy of programmed death-ligand 1 inhibitors combined with chemotherapy has become the new front-line standard of care for ES-SCLC. Emerging knowledge regarding SCLC biology, including genomic characterization and molecular subtyping, and new treatment approaches will potentially lead to advances in SCLC patient care.

Automated summary

Small-cell lung cancer (SCLC) accounts for about 15% of lung cancers and is highly aggressive. Surgical resection followed by adjuvant therapy is curative for limited-stage SCLC, but only a minority of patients are eligible for surgery. Concurrent chemo-radiotherapy is the standard treatment for inoperable limited-stage SCLC, while combination chemotherapy with programmed death-ligand 1 inhibitors has become the new front-line standard for extensive-stage SCLC. Advances in understanding SCLC biology and new treatment approaches offer potential improvements in patient care.