Updated 7 May 2008

Chemotherapy Regimens for Limited SCLC

Combination chemotherapy is mandatory for curative intent therapy of limited SCLC.

Four cycles of EP (LURADPE) has become the international standard for good performance status patients with good renal function with limited SCLC. EP is not associated with severe normal tissue toxicity when administered concurrently with full dose thoracic irradiation. The standard interval between cycles is three weeks. Cycle interval is increased to 4 weeks for one cycle during concurrent chemoradiation. Thoracic irradiation should not be interrupted because of neutropenia (regardless of severity) in the absence of clinical evidence of infection.

An advantage for topoisomerase 1 inhibitors (irinotecan or topotecan) plus cisplatin over etoposide and cisplatin has not been confirmed in North American trials and this class of agent does not combine well with thoracic irradiation.

References:

1. Ihde DH: Chemotherapy for lung cancer. N Engl J Med 327:1434-1441, 1992

2. Murray N, Turrisi A. A review of first-line treatment for small-cell lung cancer. J Thorac Oncol. 1:270-278, 2006