Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2021 Jul;32(7):839-853.
doi: 10.1016/j.annonc.2021.03.207. Epub 2021 Apr 20.

Small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up☆

A-M C Dingemans  1 , M Früh  2 , A Ardizzoni  3 , B Besse  4 , C Faivre-Finn  5 , L E Hendriks  6 , S Lantuejoul  7 , S Peters  8 , N Reguart  9 , C M Rudin  10 , D De Ruysscher  11 , P E Van Schil  12 , J Vansteenkiste  13 , M Reck  14 ; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org
Affiliations
Practice Guideline

Small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up☆

A-M C Dingemans et al. Ann Oncol. 2021 Jul.
No abstract available

Keywords: Clinical Practice Guidelines; diagnosis; follow-up; small-cell lung cancer; treatment.

PubMed Disclaimer

Conflict of interest statement

Disclosure A-MCD reports receipt of honoraria for participation in advisory boards and/or lectures from Roche, Eli Lilly, Boehringer Ingelheim, AstraZeneca, Pfizer, Bristol Myers Squibb (BMS), Amgen, Novartis, Merck Sharp & Dohme (MSD), Takeda and PharmaMar; research funding from BMS, AbbVie and Amgen. MF reports receipt of advisory board honoraria to institution from BMS, Takeda, AstraZeneca, Boehringer Ingelheim, MSD and Roche. AA reports receipt of honoraria for participation in advisory boards from AstraZeneca, Roche, MSD, BMS, Lilly, Takeda and Bayer; research grant from BMS. BB reports receipt of grants/research support to institute from AbbVie, Amgen, AstraZeneca, BeiGene, Blueprint Medicines, BMS, Boehringer Ingelheim, Celgene, Cristal Therapeutics, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline (GSK), Ignyta, IPSEN, Inivata, Janssen, Merck KGaA, MSD, Nektar, Onxeo, OSE Immunotherapeutics, Pfizer, PharmaMar, Roche-Genentech, Sanofi, Servier, Spectrum Pharmaceuticals, Takeda, Tiziana Pharma and Tolero Pharmaceuticals. CF-F reports participation in advisory boards for AstraZeneca; research funding from MSD and AstraZeneca. LEH reports research funding to institution from Roche, Boehringer Ingelheim and AstraZeneca; advisory board honoraria to institution from BMS, Lilly, Roche, Pfizer, Takeda, MSD, Amgen and Boehringer Ingelheim; speaker fees from MSD; travel/conference reimbursement from Roche and BMS; participation in mentorship program funded by AstraZeneca; fees for educational webinars from Quadia; fees to institution for interview sessions from Roche. SL reports consulting activities for MSD, AstraZeneca, BMS, Bayer and Eli Lilly. SP reports receipt of honoraria to institute for consultancy, advisory boards and/or lectures from AbbVie, Amgen, AstraZeneca, Bayer, Biocartis, Bioinvent, Blueprint Medicines, Boehringer Ingelheim, BMS, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, Roche, Foundation Medicine, Illumina, Janssen, MSD, Merck Serono, Merrimack, Mirati, Novartis, PharmaMar, Pfizer, Regeneron, Sanofi, Seattle Genetics, Takeda and Vaccibody; institutional financial support for clinical trials from Amgen, AstraZeneca, Biodesix, Boehringer Ingelheim, BMS, Clovis, Roche, Illumina, MSD, Merck Serono, Novartis and Pfizer. NR reports receipt of speaker honoraria from MSD, BMS, Roche, Boehringer Ingelheim, Guardant Health, Pfizer, AbbVie, Ipsen, Novartis, AstraZeneca, Lilly, Takeda and Amgen; fees for organising educational events from Amgen and Roche; advisory panel honoraria from MSD, BMS, Roche, Boehringer Ingelheim, Guardant Health, Pfizer, AbbVie, Ipsen, Novartis, AstraZeneca, Lilly, Takeda and Amgen; sponsorship to attend scientific meetings from Boehringer Ingelheim, MSD and Roche; research grants from Novartis and Pfizer. CMR reports consultancy for AbbVie, Amgen, Ascentage, AstraZeneca, Bicycle, Celgene, Daiichi Sankyo, Genentech/Roche, Ipsen, Jazz, Lilly, Pfizer, PharmaMar, Syros and Vavotek; serves on scientific advisory boards for Bridge Medicines and Harpoon Therapeutics. DDR reports receipt of research grants to institute from BMS, AstraZeneca and Boehringer Ingelheim; advisory board honoraria to institute from BMS, AstraZeneca, Boehringer Ingelheim and Philips; funding to institute for investigator-initiated study from Olink. PEVS reports board membership of IASLC; treasurer of BACTS; fees to institution for serving as an external expert for AstraZeneca, MSD and National Cancer Institute, France. JV reports receipt of advisory board honoraria and/or lecture fees from Boehringer Ingelheim, AstraZeneca, MSD, Novartis, Roche, Pfizer and BMS; research grant to institute from MSD. MR reports receipt of honoraria for lectures and consultancy from Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Lilly, Merck, MSD, Novartis, Pfizer, Roche and Samsung; funding for academic research from BMS and Boehringer Ingelheim.

Figures

Figure 1.
Figure 1.. Treatment algorithm for SCLC in patients with limited-stage disease (i.e. stage I-III SCLC eligible for curative treatment).
Purple: general categories or stratification; red: surgery; dark green: radiotherapy; blue: systemic anticancer therapy; turquoise: combination of treatments or other systemic treatments; white: other aspects of management. c, clinical; CRT, chemoradiotherapy; M, metastasis; MRI, magnetic resonance imaging; N, node; p, pathological; PCI, prophylactic cranial irradiation; PS, performance status; R, resection; SCLC, small-cell lung cancer; T, tumour. a After extensive pathological mediastinal staging. b The role of PCI is not well defined in patients with stage I-II SCLC, patients >70 years of age and frail patients. In these cases, shared decision making is recommended, including the option of brain MRI surveillance.
Figure 2.
Figure 2.. Treatment algorithm for SCLC in patients with extensive-stage disease (i.e. stage IV or stage III SCLC not eligible for curative treatment)
Purple: general categories or stratification; dark green: radiotherapy; blue: systemic anticancer therapy; turquoise: combination of treatments or other systemic treatments; white: other aspects of management. BSC, best supportive care; ChT, chemotherapy; G-CSF, granulocyte colony-stimulating factor; IO, immunotherapy; MCBS, ESMO-Magnitude of Clinical Benefit Scale; MRI, magnetic resonance imaging; PCI, prophylactic cranial irradiation; PS, performance status; RT, radiotherapy; SCLC, small-cell lung cancer. a ESMO-MCBS v1.1 score for new therapy/indication approved by the EMA or FDA. The score has been calculated by the ESMO-MCBS Working Group and validated by the ESMO Guidelines Committee (https://www.esmo.org/guidelines/esmo-mcbs/scale-evaluation-forms-v1.0-v1.1/scale-evaluation-forms-v1.1). b Carboplatin may be replaced by cisplatin in patients <70 years of age or based on the toxicity profile [II, C]. c In patients with a PS of ≥2, consider ChT dose reduction and/or G-CSF prophylaxis. d No brain metastasis on MRI before PCI.
Figure 3.
Figure 3.. Treatment algorithm for SCLC in patients with recurrent SCLC (i.e. second-line therapy and beyond).
Purple: general categories or stratification; blue: systemic anticancer therapy; turquoise: combination of treatments or other systemic treatments; white: other aspects of management. BSC, best supportive care; i.v., intravenous; MCBS, ESMO-Magnitude of Clinical Benefit Scale; PS, performance status; SCLC, small-cell lung cancer; TFI, treatment-free interval. a ESMO-MCBS v1.1 score for new therapy/indication approved by the EMA or FDA. The score has been calculated by the ESMO-MCBS Working Group and validated by the ESMO Guidelines Committee (https://www.esmo.org/guidelines/esmo-mcbs/scale-evaluation-forms-v1.0-v1.1/scale-evaluation-forms-v1.1).
See this image and copyright information in PMC

Comment in

References

    1. American Cancer Society. Cancer Facts & Figures 2019. Atlanta: American Cancer Society. 2019. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-.... Accessed October 20, 2020.
    1. Govindan R, Page N, Morgensztern D, et al. Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol. 2006;24(28):4539–4544. - PubMed
    1. Breitling LP, Rinke A, Gress TM. Recent survival trends in high-grade neuroendocrine neoplasms and lung cancer. Neuroendocrinology. 2020;110(3–4):225–233. - PubMed
    1. Abdel-Rahman O Changing epidemiology of elderly small cell lung cancer patients over the last 40 years; a SEER database analysis. Clin Respir J. 2018;12(3):1093–1099. - PubMed
    1. Aberle DR, DeMello S, Berg CD, et al. Results of the two incidence screenings in the National Lung Screening Trial. N Engl J Med. 2013;369(10):920–931. - PMC - PubMed

Publication types

MeSH terms