A Trial of the ECOG-ACRIN Cancer Research Group (E1508)
Small cell lung cancer (SCLC) accounts for 12% of all cases of lung cancer in the United States.1 SCLC is characterized by its rapid doubling time and the early development of metastatic disease, and for decades, combination chemotherapy, con-sisting of a platinum agent and the topoisomerase II inhibitor etoposide, has been the mainstay of systemic treatment for this disease. Approximately two-thirds of all SCLC cases have extensive-stage small cell lung cancer (SCLC-ED). Response rates to first-line chemotherapy range from 60% to 70% in patients with SCLC-ED; however, despite the impressive effi-cacy, most patients rapidly develop resistant disease, and their overall prognosis and outcome are poor. For patients with SCLC-ED, the median survival is 9 to 11 months, and only 5% of patients are alive 2 years after their diagnosis.2 Despite multiple efforts to combine chemotherapeutic and targeted agents with the standard first-line therapy, the results have been dismal.2 There is a critical need to incorporate mech-anistically based novel compounds targeting tumor cells or signaling pathways that are altered in SCLC.