Jill Feldman, Montessa Lee, Dr. Christine Lovly

In this small cell lung cancer video you will learn the answers to these questions:

  1. Have researchers found any correlation between family history and small cell lung cancer diagnoses?
  2. Are there subtypes of small cell lung cancer that are similar to those found in non small cell lung cancer?
  3. What breakthroughs in small cell lung cancer treatments are on the horizon for small cell lung cancer patients?

Small Cell Lung Cancer and Family History

The genetic determinants of small cell lung cancer (SCLC) have not received much attention because an outsized number of cases are attributed to #smoking. But a new study from the Center for Cancer Research identified specific inherited mutations that increase an individual’s risk of developing SCLC.

The study found patients with inherited mutations had a better prognosis than patients without the mutation. They stayed in remission longer than their counterparts following standard platinum-based chemotherapy. These patients may be more likely to benefit from chemotherapy and other treatments that exploit the cancer’s inability to repair damaged DNA.

Subtypes in Small Cell Lung Cancer

Although immunotherapy has become a standard of care, it has had limited success with SCLC. A study published in February 2021 may explain why; different drugs may be more or less effective for each subtype.

Researchers from The University of Texas MD Anderson Cancer Center categorized small cell lung cancer tumors into four major subtypes based on gene expression. Previous research had identified three possible subtypes but left a large number of tumors unclassified. The team pinpointed the fourth subtype by the inflamed gene signature with a high expression of multiple immune genes. They also identified potential therapeutic targets for each. The fourth group, for example, has a distinct biology that tends to be more responsive to immunotherapy.

Biomarkers Can Determine Treatment Options

Biomarker testing, also called genetic mutation testing or genomic testing, looks at the specific mutations in tumor cells. These biomarkers can then be used to determine the best treatment options for a lung cancer patient.

At the CURE® Educated Patient® Lung Cancer Summit in December 2020, Dr. Melissa Johnson discussed different biomarkers that can impact small cell lung cancer patient’s decisions. Her main focus was on the widespread PD-L1 tumor mutation burden and microsatellite instability (MSI). They play an important role in determining immunotherapy treatment for patients with SCLC.

Tumors that have high PD-L1 expression from the outset are more likely to respond to immunotherapy. This response makes it possible to initially treat these patients with immunotherapy drugs to

  1. reduce symptoms
  2. improve energy
  3. avoid the side effects of chemotherapy

What is the Future of Treatment for Small Cell Lung Cancer?

Research into effective treatments for small cell lung cancer has lagged behind research for non small cell lung cancer. In part, this is due to the fact that there are many more patient/advocates for non small cell lung cancer than for small cell lung cancer.

Chemotherapy and radiation have been the standard of care for small cell lung cancer for over 30 years. Only in the past few years has this begun to change.

Immunotherapy can be effective for some small cell lung cancer patients in combination with chemotherapy. More research is needed to determine how and when to best use immunotherapy for small cell lung cancer patients.