Published online Jan 16, 2024. doi: 10.12998/wjcc.v12.i2.405
Peer-review started: September 29, 2023
First decision: December 18, 2023
Revised: December 18, 2023
Accepted: December 26, 2023
Article in press: December 26, 2023
Published online: January 16, 2024
Small cell lung cancer (SCLC) is a common and aggressive subtype of lung cancer. It is characterized by rapid growth and a high mortality rate. Approximately 10% of patients with SCLC present with brain metastases at the time of diagnosis, which is associated with a median survival of 5 mo. This study aimed to summarize the effect of bevacizumab on the progression-free survival (PFS) and overall survival of patients with brain metastasis of SCLC.
A 62-year-old man was referred to our hospital in February 2023 because of dizziness and numbness of the right lower extremity without headache or fever for more than four weeks. The patient was diagnosed with limited-stage SCLC. He received 8 cycles of chemotherapy combined with maintenance bevacizumab therapy and achieved a PFS of over 7 mo.
The combination of bevacizumab and irinotecan effectively alleviated brain metastasis in SCLC and prolonged PFS.
Core Tip: Small cell lung cancer (SCLC) accounts for approximately 13%-15% of all lung cancer patients. A five-year survival rate of less than 7 percent makes it one of the deadliest cancers. Compared to Non-Small Cell Lung Carcinoma, SCLC has a faster doubling time in the early stages and is more likely to spread widely. Therefore, 60%-70% of SCLC is diagnosed as extensive stage at initial diagnosis. SCLC cells also show a high tendency of metastasis to the central nervous system, and 10% of patients have brain metastasis at the first visit. Here, we report a patient with extensive stage-small cell lung cancer (ES-SCLC) and brain metastases who received four lines of treatment. We used bevacizumab in combination with irinotecan as a post-fourth-line therapy in an elderly man and achieved a significant partial response.