Targeted therapies in small cell lung cancer
| Phase | Patients n | Combination regimen | Population | RR | OS/PFS | Conclusion | [Ref.] | |
| TK inhibitors | ||||||||
| Gefitinib | II | 18 | Relapsed, Rs/S | No PR, SD 11% | OS: 55 days (Rs); 254 days (S) | No clinical activity | 95 | |
| Imatinib | II | 29 | Relapsed, Rs/S (c-kit+) | No OR, no SD | OS: 4 months (Rs); 5 months (S) | No clinical activity | 96 | |
| II | 12 | Relapsed, Rs/S (c-kit+) | No OR, no SD | OS: 2 months | No clinical activity | 97 | ||
| II | 19 | ES, UT,relapsed, S | No OR | OS: 9 months (UT); 7 months (S) | No clinical activity | 98 | ||
| II | 8 | ES, no PD after first-line IP (c-kit+) | No OR | OS: 10 months; PFS: 6 months | Disease stability not maintained | 99 | ||
| II | 68 | Carboplatin/ irinotecan | ES, UT | PR 66% | OS: 8 months; PFS: 5 months | No benefit compared to chemotherapy alone | 100 | |
| Antiangiogenics | ||||||||
| Bevacizumab | II | 64 | EP | ES, UT | OR 69% | PFS at 6 months: 33% | Promising results | 101 |
| II | 72 | IP | ES, UT | CR 3%; PR 59% | OS: 11 months; PFS: 7 months | Primary end-point (12-month overall survival rate) not reached | 102 | |
| II | 34 | Paclitaxel | Relapsed, S | PR 11%; SD 56% | OS: 21 weeks; PFS: 13 weeks | Active regimen | 103 | |
| Vandetanib | II | 107 | ES/LS, CR/PR after first-line combination chemotherapy | OS: 11 (vandetanib) vs 12 months (placebo) (ns); PFS: 3 (vandetanib) vs 3 months (placebo) (ns) | No efficacy as maintenance therapy | 104 | ||
| Sorafenib | II | 89 | ES, relapsed,Rs/S | PR: 5% (S); 2% (Rs) | OS: 7 months (S); 5 months (Rs) | Clinical activity | 105 | |
| Thalidomide | III | 119 | PCDE | ES, after response to 2 cycles of PCDE | OS: 12 (thalidomide) vs 9 months (placebo) (ns) | No significant improvement in survival | 106 | |
| III | 724 | Carboplatin/ etoposide | ES/LS, UT | OS: 10 (thalidomide) vs 11 months (placebo) (ns) | No significant improvement in survival | 107 | ||
| Cediranib | II | 25 | Relapsed | PR 1 patient (unconfirmed)SD 8 patients | PFS: 8 weeks | No clinical activity | 108 |
RR: response rate; OS: overall survival; PFS: progression-free survival; TK: tyrosine kinase; EP: etoposide and cisplatin; IP: irinotecan and cisplatin; PCDE: cisplatin, cyclophosphamide, 4’-epidoxorubicin and etoposide; Rs: resistant; S: sensitive; c-kit: mast/stem cell growth factor receptor; ES: extensive stage; UT: untreated; PD: progressive disease; LS: limited stage; CR: complete response; PR: partial response; SD: stable disease; OR: overall response; ns: nonsignificant.