Treatments for recurrent small cell lung cancer

Last medical review:

Recurrent small cell lung cancer means that the cancer has come back after it has been treated. The following are treatment options for recurrent small cell lung cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. Treatment will depend on:

  • where the cancer has recurred (come back)

  • what treatments you've already had

  • your overall health

  • what you would like to do for treatment

Chemotherapy

Chemotherapy may be offered for recurrent small cell lung cancer. If the cancer has returned at least a year after treatment, you may be offered the same chemotherapy used before. This is usually cisplatin and etoposide (Vepesid).

If the cancer has recurred less than a year since treatment, or if you have side effects from cisplatin, the combination of cyclophosphamide, doxorubicin and vincristine may be used.

Single drugs that may be used with recurrent small cell lung cancer are:

  • vinorelbine

  • gemcitabine

  • irinotecan (Onivyde)

  • topotecan

Irinotecan and topotecan may be given into a vein (intravenously) or by mouth (as a pill).

Lurbinectedin (Zepzelca) may be offered for recurrent small cell lung cancer that doesn't respond to, or stops responding to, treatment with cisplatin.

Radiation therapy

External radiation therapy may be offered for small cell lung cancer that has come back in the lung if it hasn't been used before.

It may be used to treat small cell lung cancer that has spread to the bones, brain or liver.

Find out more about bone metastases, brain metastases and liver metastases.

Endobronchial therapies

Endobronchial therapies remove a blockage caused by the cancer inside the lung and help with symptoms, such as problems with breathing, pain or coughing up blood.

The type of endobronchial therapy used will depend on how quickly the symptoms must be treated.

If you can't have or don't want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don't work anymore, they're not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can't have or don't want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Talk to your doctor about clinical trials open to people with small cell lung cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Questions to ask about treatment

To make the decisions that are right for you, ask your healthcare team questions about treatment.

Expert review and references

  • Stephen Lam, MD, FRCPC
  • American Cancer Society. Treating Small Cell Lung Cancer. 2019. https://www.cancer.org/cancer/lung-cancer/treating-small-cell.html.
  • Cancer Care Ontario. Small Cell Lung Cancer Treatment Pathway Map. 2019: Version 2019.05.
  • Hann CL, Wu MA, Rekhtman N, Rudin CM. Small cell and neuroendocrine tumors of the lung. DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer; 2019: 49:671–699.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer (Version 1.2021). 2020.
  • PDQ® Adult Treatment Editorial Board. Small Cell Lung Cancer Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2020. https://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq.
  • PDQ® Adult Treatment Editorial Board. Small Cell Lung Cancer Treatment (PDQ®) – Patient Version. Bethesda, MD: National Cancer Institute; 2020. https://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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