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Lung Cancer and Personalized Medicine: Novel Therapies and Clinical Management pp 149–174Cite as

Personalized Therapy of Small Cell Lung Cancer

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Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 890))

Abstract

Small cell lung cancer (SCLC) is an aggressive, poorly differentiated neuroendocrine carcinoma with distinct clinical, pathological and molecular characteristics. Despite robust responses to initial chemotherapy and radiation, the prognosis of patients with SCLC remains poor with an overall 5-year survival rate of less than 10 %. Despite the fact that numerous molecularly targeted approaches have thus far failed to demonstrate clinical utility in SCLC, further advances will rely on better definition of the biological pathways that drive survival, proliferation and metastasis. Recent next-generation, molecular profiling studies have identified many new therapeutic targets in SCLC, as well as extreme genomic instability which explains the high degree of resistance. A wide variety of anti-angiogenic agents, growth factor inhibitors, pro-apoptotic agents, and epigenetic modulators have been evaluated in SCLC and many studies of these strategies are on-going. Perhaps the most promising approaches involve agents targeting cancer stem cell pathways and immunomodulatory drugs that interfere with the PD1 and CTLA-4 pathways. SCLC offers many barriers to the development of successful therapy, including limited tumor samples, inadequate preclinical models, high mutational burden, and aggressive tumor growth which impairs functional status and hampers enrollment on clinical trials.

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Authors and Affiliations

  1. Division of Hematology/Oncology, University of Michigan, C411 Med Inn—SPC 5848, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109-5848, USA

    Bryan J. Schneider M.D.

  2. Division of Hematology/Oncology, University of Michigan, C350 Med Inn—SPC 5848, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109-5848, USA

    Gregory P. Kalemkerian M.D.

Authors
  1. Bryan J. Schneider M.D.
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  2. Gregory P. Kalemkerian M.D.
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Correspondence to Gregory P. Kalemkerian M.D. .

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Editors and Affiliations

  1. Wayne State University, Karmanos Cancer Institute, Detroit, Michigan, USA

    Aamir Ahmad

  2. Karamanos Cancer Institute, Wayne State University, Detroit, Michigan, USA

    Shirish M. Gadgeel

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Schneider, B.J., Kalemkerian, G.P. (2016). Personalized Therapy of Small Cell Lung Cancer. In: Ahmad, A., Gadgeel, S. (eds) Lung Cancer and Personalized Medicine: Novel Therapies and Clinical Management. Advances in Experimental Medicine and Biology, vol 890. Springer, Cham. https://doi.org/10.1007/978-3-319-24932-2_9

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