Lntroduction to regular therapies and clinical trial drug targets currently on the market for patients with small cell lung cancer

Small cell lung cancer is a rare and rapidly growing lung cancer. Anyone can develop small cell lung cancer, but it usually affects people who smoke for a long time. The only way to prevent small cell lung cancer is to stop smoking. Small cell lung cancer is divided into two types: small cell carcinoma and mixed small cell carcinoma.

Standard treatment

Surgery:if cancer is present in only one lung and nearby lymph nodes, surgery may be considered. Because small cell lung cancer usually affects both lungs, surgery alone is less likely to be used. During surgery, the doctor will also remove the lymph nodes to check for cancer cells. Sometimes, surgery may be used to sample lung tissue to confirm the exact type of lung cancer.

When doctors remove all the cancer cells that can be seen during surgery, some patients may receive chemotherapy or radiation after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy.

Chemotherapy:use drugs to stop the growth of cancer cells by killing the cells or stopping them from dividing. Chemotherapy for small cell lung cancer is usually systemic, I .e., administered intravenously or orally. In this way, the drug enters the blood circulation and can reach cancer cells throughout the body. Combinations of these chemotherapy drugs may be used together. Some other chemotherapy drugs not listed may also be used. Chemotherapy can also be used in combination with other types of treatment, for example in combination with radiotherapy or immunotherapy drugs.

Radiation therapy:radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or inhibit their growth. External radiation therapy uses machines outside the body to focus radiation on the area where the cancer is located. External radiation therapy can be used to treat small cell lung cancer and can also be used as palliative treatment to relieve symptoms and improve quality of life. To reduce the risk of cancer spreading to the brain, radiation treatment of the brain may also be done.

Immunotherapy:immunotherapy helps the body's immune system fight cancer. Biomarker testing is needed to predict response to certain immunotherapy drugs.

laser treatment:laser treatment is a cancer treatment that uses a laser beam to kill cancer cells.

Clinical Trials Drug Targets

With the in-depth understanding of the molecular mechanism of small cell lung cancer, more and more new drugs and targeted therapies have entered the clinical trial stage. These drugs mainly target specific molecular targets in cancer cells in order to improve the therapeutic effect and reduce side effects. At present, there are these drugs for DLL3 targets in domestic small cell lung cancer clinical trials: Tarlatamab (targeting DLL3 and CD3), ZL-1310 (targeting DLL3), FZ-AD005 (targeting DLL3), BI 764532 (targeting DLL3/CD3) and VEGF targets: PM8002 (targeting PD-L1 and VEGF), recombinant anti-VEGFR2 fully human monoclonal antibody (JY025) injection (targeting VEGF), recombinant anti-PD-1 humanized monoclonal antibody injection (targeting PD-1), TQB2450 injection (targeting PD-L1), etc.

DLL3, an inhibitory Notch ligand, is highly expressed in small cell lung cancer and other neuroendocrine tumors, but is minimally expressed in normal tissues. This is the ideal target. Most of the targeted drugs for DLL3 are in the development and clinical trials stage.

Vascular endothelial growth factor (VEGF) is the most important protein with pro-angiogenic function. The VEGF family includes VEGF-A, which stimulates angiogenesis and vascular permeability by binding to its receptors VEGFR-1(Flt-1) and VEGFR-2(KDR/Flk1). VEGF-C and VEGF-D bind to another receptor, VEGFR-3(Flt-4), which regulates lymphangiogenesis. VEGF overexpression in small cell lung cancer is associated with poor prognosis. Current Domestic Small Cell Lung Cancer Clinical Trials

PD-1 and its ligands PD-L1 play a key role in tumor immunity and the formation of tumor microenvironment, and are closely related to the occurrence and development of tumors. Blocking the PD-1/PD-L1 pathway can reverse the tumor microenvironment and enhance the endogenous anti-tumor immune response.

the treatment of small cell lung cancer still faces many challenges, with the continuous advancement of scientific research and clinical trials, the treatment options for patients will become more and more abundant, and the efficacy is expected to be significantly improved.