Management of Extensive Small-Cell Lung Cancer

The treatment of patients with extensive SCLC still remains palliative. In this setting, it is highly important to include patients in clinical trials that evaluate new drugs. For patients who can not be included in trials, the treatment should be tailored according to performance status and patients’ wishes. Three options can be discussed: a four-drug combination when performance status is unaltered, a standard etoposide/cisplatin regimen when there is a minimal alteration of performance status, and when the patient asks for a good quality of life. The combination of carboplatin and etoposide should be given only to patients who present an important performance status alteration or a contraindication to a standard chemotherapy.