The true incidence of SCLC in the United States is unknown, but estimates range from 25 to 150 cases per 100,000 population. A study in 1983 found that 30% of the SCLC cases examined were diagnosed at stage I and II, while 10% were diagnosed at stage III. In general, in the United States the pathologic staging of SCLC is well correlated with prognosis. The significance of stage IB and II disease remains unclear. Although this study was performed over 20 years ago, demographic trends over the last decade suggest an increasing frequency and a later age of diagnosis of SCLC.
Although there has been some improvement in survival rates, the 5-year survival rate remains poor. This is likely due to low number of cases treated in hospitals, which could affect treatment outcome. Since SCLC is rare in most countries, lack of adequate diagnostic resources could be one of the reasons for this poor prognosis. Survival rates are higher when the disease is diagnosed early and staged appropriately. Treatment options include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, and palliative care. Palliative care should be offered to patients who are unable to undergo curative therapies.
Data from a recent study of this study do not support a familial susceptibility to SCLC. Considering the low prevalence of SCLC in the general population, we recommend caution in applying these findings to the general population.
The New York Cancer Registry indicated a significant increase in SCLC incidence over a time frame of 3 decades, particularly among non-Hispanic white males aged 50–69 years old. Findings from a recent study has shown a significant association between smoking and SCLC. Findings from a recent study support the need for further investigations to identify risk factors involved in the development of SCLC.
There are many immunotherapies for SCLC; they could provide an additional option for patients who have no good response to chemotherapy. The choice of therapeutic schedule depends upon which drug is used as well as the stage of disease.
MK-4830 has not undergone any phase III clinical trial in SCLC. However, several other agents have undergone clinical trials in SCLC, including MK-4870, MK-4658, MK-7508, and MK-1791. These studies showed that MK-4870 was well tolerated and was moderately active in patients with SCLC. However, more data are needed regarding the efficacy of MK-4870 compared to MK-4830 in patients with SCLC. MK-7508 showed promising results in a phase II trial, manifested as an increased progression-free survival rate.
There are several effective chemotherapy regimens for SCLC but they have limited benefit compared with supportive care alone. Radiotherapy is often used in combination with surgery and chemotherapy for people with locally advanced disease (stages III and IV), but its benefit is less clear. One review found no evidence to support chemotherapy plus radiotherapy for people whose disease has spread beyond the lungs. People with early-stage disease may benefit from adjuvant therapy; however, more research is needed before this approach can be recommended routinely. New approaches such as immunotherapy are being studied for use in conjunction with standard treatments. These treatments may improve outcomes for people with SCLC if they work by slowing growth of tumor cells or reducing their ability to invade healthy tissues.
MK-4830 was not commonly used in combination with other therapies In a recent study. Further research should be conducted to determine more accurately the frequency and effectiveness of MK-4830 use in combination therapies.
Thus far, this compound has been tested in three different models of human cancers (see below). It appears to be an effective anti-cancer agent in both solid tumors and hematologic malignancies. Because of its unique mechanism of action, it may have applications beyond cancer treatment.
To cure SCLC is an unachievable goal because of its aggressive nature and poor prognosis. Currently there are no effective therapies available for SCLC and many patients die within 3 years of diagnosis. Given the poor survival rate of SCLC patients, future research should focus on improving outcomes through innovative multimodal approaches.
Small cell lung carcinoma (SCLC) has been associated primarily with tobacco smoking. It is possible that SCLC development could be increased if there was a higher prevalence of smokers among the Patna population, particularly during childhood.