The rapid course of small cell lung cancer and treatment options - case report

 Small cell lung cancer (SCLC) is a disease with an unfavorable prognosis. Factors contributing to losing prognosis include: systemic disease, many comorbidities, smoking and the patient's low performance status (PS). Early diagnosis and treatment initiation seem to be the most significant in the diagnostic and therapeutic process. However, most of patients are diagnosed in metastatic stage. The basic method of metastatic SCLC treatment is chemotherapy, which, according to the latest research (CASPIAN, IMPower133), can be linked to immunotherapy, which is associated with a major improvement in therapeutic efficiency. We present a case of 64-year-old man with a rapidly progressive course of small cell lung cancer, where the fulminant course of the disease led to death within about one month of the first imaging examinations, equally preventing the initiation of systemic treatment. The presented case shows how important is paying attention to the first symptoms, timely diagnosis of the disease and initiation of effective and targeted therapy in patients with SCLC

Immunochemotherapy in a 25-year-old male patient with small-cell lung cancer

Lung cancer is the leading cause of cancer-related deaths, both in males and females. Small-cell lung cancer (SCLC) is a strongly tobacco-dependent type of lung cancer characterized by aggressiveness, rapid growth, and a high tendency to metastasize. SCLC is the most commonly diagnosed in an advanced — metastatic — stage in patients with many comorbidities and inadequate performance status. However, based on the most current recommendations, chemotherapy in combination with immunotherapy at the extensive stage (ES) of SCLC, significantly improves the therapeutic efficiency. Here, we present a case of a 25-year-old man, diagnosed with SCLC, with a medical history of 10 years of smoking e-cigarettes and marijuana as well as the use of amphetamine and alcohol. In the diagnosis process, considering the young age of the patient, the next-generation sequencing (NGS) was performed, but no molecular alterations in oncogenes were found. During the immunochemotherapy with atezolizumab, carboplatin, and etoposide, immune-related adverse events (irAEs), in the form of hepatotoxicity, were observed. After the toxicity subsided, the immunotherapy was continued with a very good effect and tolerance. The patient has remained in partial remission for 9 months. The presented case highlights the possibility of treatment continuation despite mild adverse events triggered by immunotherapy and the need for more research in the group of young patients diagnosed with SCLC