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SCLC — SCE Medical Oncology MCQ

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EasyLung CancerSCLCSCE Medical Oncology

A 60-year-old man with extensive-stage SCLC progresses 4 months after completing first-line carboplatin-etoposide-atezolizumab. This is classified as platinum-resistant relapse. What is the standard second-line chemotherapy?

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Correct answer: B — Topotecan (oral or IV)

For platinum-resistant ES-SCLC (relapse <6 months from platinum completion), topotecan (IV or oral) is the standard second-line option (NICE TA184). Response rates are modest (approximately 10-20%). CAV (cyclophosphamide, doxorubicin, vincristine) is an alternative. For platinum-sensitive relapse (>6 months), platinum rechallenge can be considered. Lurbinectedin is an emerging option. NICE rejected tarlatamab (TA1091) for third-line, though it received MHRA approval.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer