Newswise — Oncologists face extremely difficult decisions when treating patients with advanced small-cell lung cancer (SCLC), a less common but more aggressive form of cancer. Typically, treatment for SCLC entails chemotherapy or radiation. But when the disease is advanced or recurring, patients often are in poor health overall and are less equipped to handle the toxicity and devastation of powerful cancer treatments.

However, according to a retrospective analysis conducted by Joseph Treat, MD, professor of medicine at Temple University School of Medicine and medical director of the Fox Chase-Temple University Cancer Center, even patients with advanced SCLC can tolerate and benefit from the chemotherapy drug topotecan.

Topotecan, the only FDA-approved chemotherapy for recurring SCLC, works by damaging DNA. This action in turn interferes with the division of cancer cells, slowing progression of the disease.

"All patients, regardless of their overall health, tolerated topotecan similarly," said Treat. "And all patients experienced similar benefits related to tumor growth, disease progression and symptom relief." Perhaps most significantly, Treat added, the drug helped the sickest patients improve their overall health and cope better with their day-to-day routines.

"When our patients are in poor health, we often struggle over whether to subject them to any treatment at all and have to carefully weigh the benefit against the potential harm. This analysis identifies a new option for patients who previously had none," said Treat.

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