Subsequent Treatment for Small Cell Lung Cancer Limited Stage IIB–IIIC After Prior Chemoradiation Did Not Achieve Disease Response
Small cell lung cancer (SCLC), limited stage, clinical stage IIB–IIIC (T3–4,N0,M0 or T1–4,N1–3,M0) in a patient with good performance status (ECOG PS 0–2), where the initial treatment course did not produce a complete or partial response on imaging.
First-line treatment was concurrent thoracic radiation with platinum-based systemic chemotherapy, followed (when tolerated) by consolidation immunotherapy. This subsequent protocol applies when imaging after that initial therapy did not demonstrate a complete or partial disease response — the threshold required for the prior line to be considered successful.
For patients who retain good performance status (PS 0–2) at this point, a structured set of subsequent systemic therapy options is available. Among preferred choices is tarlatamab-dlle; additional cytotoxic and immunotherapy alternatives are considered depending on prior treatment history. The complete evidence-based selection and sequencing is in the full protocol.
Disease response (complete or partial) on CT, assessed after every 2–3 cycles of systemic therapy.
References
- Good performance status (PS) (0–2)
- Limited stage IIB–IIIC (T3–4,N0,M0; T1–4,N1–3,M0)
- Tarlatamab-dlle (category 1)
- The Panel recommends response assessment using CT with contrast of the C/A/P after every 2 to 3 cycles.