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Small Cell: After First Line Therapy

Small Cell: After First Line Therapy

December 14, 2021
Sanjay Juneja, MD
Sanjay Juneja, MD

Medical Oncology

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If you progress on that first line platinum cytotoxic therapy plus immune therapy, there are other options. Commonly, people use topotecan for decades as a second line option. This is usually a chemo you’re given five days in a row and then have several weeks off before getting another cycle. We also use Lurbinectedin as a second or third line option, and it really depends on the patient which one you go to for a second line. However, there are all kinds of drugs being studied, especially targeted drugs, to see if we can control small cell lung cancer better. If you go through those three therapies, we do use single agent chemotherapies that we use in other cancers, but they don’t work as well and usually have maybe a 20% chance of being effective. Whereas Lurbinectedin and topotecan have about a 30 to 40%, widely varying depending on the situation. Some of the single agent drugs we use after the core three we discussed are paclitaxel, gemcitabine, possibly docetaxel, other common backbone drugs that we use in other cancer types.