Le carcinome bronchique à petites cellules : traitement de la maladie disséminée

Small cell lung cancer (SCLC) is an aggressive tumor with a strong association to heavy tobacco smoking. The majority of cases is metastasized at initial clinical presentation. SCLC is an extremely chemosensitive neoplasm and the combination of a platinum-derivative with etoposide represents the chemotherapeutic standard in terms of effectiveness and toxicity profile. Recently, extended stages of SCLC have benefited from the addition of prophylactic pancranial irradiation, resulting in a considerable gain in survival. Unfortunately, with its high rate of relapse, SCLC remains a tumor with a dismal prognosis, while the road towards new effective therapies is paved with failures and disillusion. Nevertheless, new chemotherapeutic agents and several targeted molecular therapies are being evaluated, in an effort to hopefully achieve the “holy Grail” of treatment in SCLC : that is a long term consolidation of a promising initial response.