This protocol applies to patients with limited-stage SCLC (clinical stage IIB–IIIC) and poor performance status (ECOG 3–4) driven by the disease itself, whose prior line of systemic treatment did not reach the intended response goal on imaging.
Limited-stage SCLC, stages IIB–IIIC, with ECOG performance status 3–4 attributable directly to the SCLC. Poor functional status at this stage reflects the disease burden and shapes the management approach significantly.
The preceding treatment was systemic therapy with or without radiotherapy (concurrent or sequential). The intended goal — complete or partial response of disease on imaging — was not achieved. This failure is the trigger for escalation to the present protocol.
The path forward is determined by whether performance status has improved. For patients whose PS has recovered to 0–2, subsequent systemic therapy is considered, with multiple cytotoxic and immunotherapy-class agents available as options. For patients who remain at PS 3–4, management pivots to palliative symptom control — with localised radiotherapy to symptomatic sites forming one component of that approach. The full structured regimen specifying agent selection, sequencing, and continuation criteria is available via the link below.