SCLC — SCE Medical Oncology MCQ

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ModerateLung CancerSCLCSCE Medical Oncology

A 70-year-old man with extensive-stage SCLC on atezolizumab maintenance after completing carboplatin-etoposide-atezolizumab develops progressive disease. Topotecan is being considered as second-line. What is the platinum-free interval that classifies SCLC as 'sensitive' versus 'resistant' to re-challenge?

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Correct answer: B — 3 months

In SCLC, the platinum-free interval (time from last platinum dose to relapse) defines sensitivity: sensitive relapse (≥90 days/3 months from platinum completion) — higher response to platinum re-challenge; resistant relapse (<90 days) — poor response to further platinum. This differs from ovarian cancer where the 6-month threshold is used. For sensitive-relapse SCLC, platinum re-challenge is an option alongside topotecan. For resistant relapse, topotecan or clinical trial enrolment (lurbinectedin) is preferred.

Reference: ESMO 2024 SCLC Guidelines; NICE TA184 Topotecan