Small cell lung cancer is a highly aggressive, difficult to treat neoplasm. Among all lung tumors,
small cell lung cancers account for about 20%. Patients typically include heavy smokers in 70s
age group, presenting with symptoms such as intrathoracic tumors growth, distant spread or paraneoplastic
syndromes at the time of diagnosis. A useful and functional classification divides small cell lung
cancers into limited disease and extensive disease. Concurrent chemo-radiotherapy is the standard
treatment for limited disease, with improved survival when combined with prophylactic cranial irradiation.
Platinum compounds (cisplatin/carboplatin) plus etoposide remain the cornerstone for extensive
disease. Nevertheless, despite high chemo- and radio-sensitivity of this cancer, nearly all patients relapse
within the first two years and the prognosis is extremely poor. A deeper understanding about small
cell lung cancer carcinogenesis led to develop and test a considerable number of new and targeted
agents but the results are currently weak or insufficient. To date, small cell lung cancer is still a challenge
for researchers. In this review, key aspects of small cell lung cancer management and controversial
points of standard and new treatments will be discussed.