Chemotherapy of small-cell lung cancer

Combination chemotherapy has become the cornerstone of management for patients with small-cell lung cancer. Although the majority of patients are palliated, most continue to die of their disease. Studies designed to improve treatment results and to understand the basic biology of this neoplasm are continuing. Several strategies are now being investigated, including the use of non-cross-resistant chemotherapy, dose intensification, manipulation of the duration of therapy, combined modality therapy, and salvage chemotherapy. Studies in these areas have not yet yielded results that have definitively improved response rates or survival. It appears that further therapy after remission induction has not yet proven beneficial. This paper will review selected areas of therapeutic investigation.