About 15 percent of lung tumors are small cell lung cancer. Treatment for this aggressive and deadly malignancy has remained nearly unchanged for decades. Recently, however, immunotherapy drugs have modestly extended patient survival. But researchers are trying to do more.
Fred Hutchinson Cancer Research Center small cell lung cancer expert Dr. David MacPherson is working to understand the biology of the disease in order to develop more effective, targeted therapies. He chatted about his most recent work, published in the journal Science Signaling, as well as the state of small cell lung cancer research and what gives him hope for the future. The interview has been edited and condensed.
Can you give us a primer on small cell lung cancer, and why more research is needed?
This is one of the most aggressive of all cancer types. It’s also about the sixth most frequent cause of cancer deaths in the U.S. But despite the high number of patients dying from small cell every year, there have been relatively few labs that have historically been studying this disease. We have a very poor understanding of the biology of small cell compared to a lot of other prevalent tumor types.
Until very recently the treatment was the same chemotherapy as it was about 30 years ago. In about two-thirds of cases, patients respond very well, but the problem is that the patient then comes back to the clinic months later with chemotherapy-resistant, recalcitrant tumors. There’s very little that can be done for those patients. The recent addition of immune checkpoint inhibitors to the chemotherapy regimen has provided some improvements in response and standard of care, but extensions in survival were modest. It’s really a tumor type where we need to do a better job in the clinic.