Cancer bronchique à petites cellules : recommandations thérapeutiques et nouvelles voies de recherche

Epidemiology of small cell lung cancer, although decreasing over the past three decades, remains high; the best treatment strategies do not allow more than 5-10% long-term survival in the extended stages and 15-20% in limited stages. Chemotherapy is the standard treatment for small cell cancer insofar as patients frequently present extensive stage at time of diagnosis. Moreover, small cell lung cancer could be considered as a potential systemic disease; Standard chemotherapy consist of platinum-etoposide based doublet. Patients with limited disease at time diagnosis are eligible for concomitant early chemo-radiotherapy; prophylactic crania irradiation is indicated for patients in complete remission after chemotherapy whatever the initial stage of the disease. In the near future, the therapeutic armamentarium might gain new anticancer drugs and non-targeted cytotoxic agents on certain adhesion molecules, some receptors for growth factors and/or inhibiting angiogenesis process. Finally, inhibitors of checkpoint proteins might be discussed.