In patients with new diagnosis/recurrent sclc, only a small fraction of them can be made "free of disease" regardless of their treatment regimen, with a chance of long term survival and disease control.
In a recent study, findings indicate that the use of chemotherapy and radiotherapy alone in sclc is not effective. Chemoradiotherapy offers the best treatment when feasible in patients with extensive-stage sclc.
There are an estimated 34 deaths from SCLC a year for men aged 25-64 years. We cannot measure extrapolated absolute numbers of cancer deaths in this age group from population-based studies like the Behavioral Epidemiologic Catchment Area Survey because age groups are not reported on death certificates. However, one study of the National Health Interview Survey (1982-1987) estimated that SCLC accounted for 0.5% (0.5 per 1,000) of all deaths. A large study of death certificates in the United States from 1977-1989 identified 748 cases of SCLC per year. Based on the above estimates, one would expect 590 SCLC cases a year among men age 25-64 years.
A careful history with emphasis on smoking cessation and history of previous lung cancer is important for the evaluation of patients with squamous cell carcinoma of the lungs. Examination, radiologic imaging, and lung biopsy should be obtained as part of initial evaluation or followup. There should also be careful consideration of histopathology for staging and classification. The most common initial radiologic feature of extensive-stage SCLC is a mass or mass-like area of consolidation on chest CT or radiographs, often corresponding to a homogenous solid mass or multifocal solid masses. This finding is associated with a very poor prognosis, even with multimodal therapy.
A history of tobacco smoking is the leading cause of SCLC. A history of smoking may result in SCLC by at least two mechanisms: carcinogens or by chronic inflammation that has been shown to promote neoplastic transformation. These mechanisms need not be mutually exclusive and the current study does not exclude a potentially complementary role for other exposures.
SCLC is an aggressive and rare form of lung cancer. Typically, it originates in the upper right or lower lobe. It has a poor prognosis and has a 5-year survival rate of 17-18%; this rate is in contrast with other types of lung cancer, which have a 5-year survival rate of 50-70%. SCLC is the second most common form of lung cancer in the US, after lung adenocarcinoma.
Small cell lung carcinoma (sclc) has the worst prognosis among all types of NSCLC, especially in young males and those who are nondiabetic. However, patients who developed extensive-stage sclc had a mean age of 47 years and a slight male predominance (60%) as compared with those who did not develop extensive-stage sclc (32% and 49%, respectively, P = 0.006). Results from a recent paper suggest that patients who developed extensive-stage sclc tended to be a different population from those who did not develop extensive-stage sclc.
The limited data to date suggest that krt-232 displays antitumor activity at a low dosage and will be appropriate for clinical development. As krt-232 may induce peripheral side effects such as insomnia and diarrhea, future clinical studies will need to be vigilant in evaluating the incidence and severity of these side effects and their impact on quality of life.
With a median survival of 6.3 months, sclc can cause serious and permanent disease in a substantial proportion of young adults presenting with metastatic disease.
In our present preclinical study, no significant adverse side effects are observed in the mice. Results from a recent clinical trial suggest that krt-232 may be a good candidate for clinical trials.
Results from a recent paper has demonstrated that systemic krt-232 treatment reduced tumor growth. Additionally, tumor necrosis, edema, and vascular permeation are all reduced following systemic krt-232 treatment. Further, krt-232-mediated apoptosis is thought to be both caspase dependent and mitochondria-dependent. Overall, the study demonstrated that systemic krt-232 treatment significantly reduced tumor volume.