Cisplatin, etoposide, and irinotecan for relapsed small-cell lung cancer

Small-cell lung cancer (SCLC) is one of the most chemosensitive solid tumors. Unfortunately, a majority of patients will experience relapse of their disease within 1 year of completing treatment. Median survival for patients with relapsed disease is dismal at about 5–6 months even with best available therapy. Good performance status and sensitivity to first-line chemotherapy are significant prognostic factors of survival in patients treated for relapsed SCLC (1). Therapy options for relapsed SCLC remain limited, due to poor efficacy of most chemotherapy regimens and the poor performance status of many of these patients at relapse. Currently, topotecan is the only FDA-approved agent for the treatment of relapsed SCLC based on a phase III trial that demonstrated improvement in survival and quality of life (QOL) compared to best supportive care (2).