Case 2: Treatment of Recurring SCLC With Brain Metastasis and AE Management

A second case scenario illustrates the challenges of treating relapse, particularly when metastases involve the brain and bone. Panelists highlight that recurrence timing, prior therapy, and patient frailty all guide selection between platinum rechallenge and alternative systemic therapies. Localized radiation may be integrated to manage symptomatic lesions.

Managing toxicities is central to maintaining treatment adherence. Common issues such as neutropenia, fatigue, and hepatic dysfunction are addressed through dose modification, supportive medications, and frequent monitoring. The conversation also focuses on supporting older or socially isolated patients, emphasizing transportation coordination, simplified regimens, and caregiver involvement.

By combining medical management with practical support, clinicians can extend therapy duration and maintain quality of life even in complex recurrent cases.