Oncology Intelligence

Lung Cancer
The two main types of lung cancer are small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). SCLC is a type of high-grade neuroendocrine carcinoma defined by light microscopy as a tumor with cells that have a small size, a round-to-fusiform shape, scant cytoplasm, finely granular nuclear chromatin and absent or inconspicuous nucleoli. Historically, oat cell and polygonal cell types microscopically identify SCLC. An intermediate subtype was identified in 1981, and the current subclassification recognizes only two subtypes: pure SCLC and combined SCLC.
Approximately a third of SCLC patients have tumors confined to the hemithorax of origin, the mediastinum, or the supraclavicular lymph nodes at the time of diagnosis. These patients are designated as having limited-stage disease (LD). Patients with tumors that have spread beyond the supraclavicular areas are said to have extensive-stage disease (ED). SCLC grows and spreads faster than NSCLC, and is rare in nonsmokers. Prognosis for patients with SCLC is poor, with a median survival from diagnosis of 2-4 months without treatment. Combining chemotherapy and thoracic radiotherapy is now the standard first line treatment for LD SCLC with randomised controlled trials reporting a median survival of between 14 and 18 months.
There are approximately 220,000 new cases from lung cancer (NSCLC and SCLC combined) in the United States each year, accounting for about 13% of all cancer diagnoses. SCLC accounts for approximately 15% of bronchogenic carcinomas. Approximately 160,000 people die from lung cancer (NSCLC and SCLC combined) in the United States each year, accounting for about 27% of all cancer deaths. The 5-year survival for SCLC (6%) is lower than that for NSCLC (21%).
The worldwide SCLC market is approximately $195 million/year. While the incidence per 100,000 has decreased steadily as the percentage of people who smoke decreases, the total number of smokers worldwide continues to grow as the population grows. In 1965 42% of adults in the US smoked, whereas about 17% did in 2014. However, the number of smokers worldwide has grown from 750 million in 1980 to a billion now. New development in the SCLC pipeline is concentrated on luxury biologics. As a result of the increased number of smokers combined with a change in focus to higher priced, potentially more efficacious biologics, the SCLC market is expected to grow to over $2 billion/year by 2020.
Historic & ongoing SCLC clinical trials
Lung Cancer
Chemotherapy alone or combined with radiation is the usual treatment for SCLC. SCLC is more responsive to chemotherapy and radiation therapy than other cell types of lung cancer; however, a cure is difficult to achieve because SCLC has a greater tendency to be widely disseminated by the time of diagnosis. Drugs approved for SCLC include: etoposide, methotrexate, mechlorethamine, and topotecan.
Novel Therapies in Development
SCLC Therapies in Development
NSCLC Development Snapshot