Extensive small-cell lung cancer: a treatment overview.

New cases of lung cancer will be diagnosed in an estimated 164,100 Americans in 2000, and approximately 25% or 41,000 of those cases will be small-cell lung cancer (SCLC). Despite initial sensitivity to chemotherapy, only 10% of all patients with SCLC achieve significant long-term survival. Studies have yet to demonstrate a significant survival advantage for maintenance chemotherapy. In addition, it appears that chemotherapy is effective for only four to six cycles in the treatment of SCLC, and there is no defined role for dose escalation. In extensive disease, no chemotherapy combination has exhibited a definitive survival advantage although it appears that single-agent etoposide (VePesid, VP-16) may be inferior to combination intravenous chemotherapy. Several new agents with significant activity in SCLC await further study.