Current and Emerging Therapeutic Strategies for Limited- and Extensive-Stage Small-Cell Lung Cancer

作者：Shalata W, Naamneh R, Najjar W, Asla M, Abu Gameh A, Abu Amna M, Saiegh L, Agbarya A · 发表于：Medical sciences (Basel, Switzerland) · 年份：2025 · DOI：10.3390/medsci13030142 · 被引用次数：75 · 研究领域：Small Cell Lung Carcinoma、Lung Neoplasms、Humans、Immunotherapy、Neoplasm Staging、Chemoradiotherapy

BACKGROUND: Small-cell lung cancer (SCLC) is a highly aggressive neuroendocrine malignancy characterized by rapid growth, early metastatic dissemination, and a dismal prognosis. For decades, treatment paradigms remained largely stagnant, particularly for extensive-stage disease (ES-SCLC). However, the last five years have witnessed a significant evolution in the therapeutic landscape. METHODS: The information for this article was gathered by synthesizing data from several key sources. This article synthesizes the evidence supporting current standards of care for both limited-stage (LS-SCLC) and ES-SCLC, incorporating data from pivotal clinical trials, a network meta-analysis of first-line chemoimmunotherapy regimens, and a critical appraisal of international treatment guidelines, and a critical analysis of international treatment guidelines from prominent organizations like the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO). This comprehensive approach allows for a robust and well-supported summary of the current therapeutic landscape. RESULTS: For limited-stage SCLC (LS-SCLC), concurrent chemoradiotherapy (cCRT) remains the curative-intent standard, but its efficacy is now being augmented by consolidative immunotherapy, as demonstrated by the landmark ADRIATIC trial. The role of prophylactic cranial irradiation (PCI) in LS-SCLC is being re-evaluated in the era of high-sensitivity brain imaging and concerns over neurotoxici...