Cancers bronchiques à petites cellules étendus Traitement standard et nouvelles approches thérapeutiques

Extensive-stage small-cell lung cancer (ES-SCLC) represents 70% of SCLC. Firstline treatment is based on chemotherapy. Cisplatin or carboplatin-etoposide combination is the standard chemotherapy. Objective response is around 60 to 75%. Maintenance chemotherapy or dose-intensification strategies did not improve survival. In asian population, cisplatine-irinotecan combination gives better results in terms of survival than cisplatine-etoposide. Topotecan is the only approved drug in second-line treatment. Reintroduction of the first-line chemotherapy regimen is a good option for chemo-sensitive patients. Use of anti-angiogenic agents is not recommanded. Currently, no targeted therapy can be use in SCLC. Molecular characterization of SCLC is at the beginning. The development of immunotherapy and check-points blockade could be a future direction for ES-SCLC treatment. Studies are ongoing. Finally, prophylactic cranial irradiation is recommanded for good responder patients to chemotherapy.