There are approximately 2700 new cases of lung cancer in Ireland each year with small cell lung cancer accounting for 13-15%. Most patients present with extensive stage disease, which is defined as spread of disease beyond what can be reasonably covered in a single radiation field. For the last three decades treatment options for these patients have been limited to platinum based chemotherapy. 5 year survival rates remained stubbornly low at 5%, with 1 year survival rates of 25.7% in Ireland over the period 2004- 2007. This has changed in the last five years with the addition of immunotherapy now becoming the standard of care in the extensive stage setting.
There were several challenges associated with improving outcomes for people with small cell lung cancer. It often presents with rapid onset of symptoms and at a late stage, and although usually initially sensitive to platinum based chemotherapy it relapses quickly. It also occurs almost exclusively in those with a heavy smoking history and if a patient’s baseline health is poor, they may be unable to tolerate second or third line treatment.
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