Because small cell lung cancer (SCLC) is rare, less is known about the disease compared with other lung cancers. At Duke Cancer Institute (DCI), however, thoracic oncology experts such as Kaitlin Bevers, MD, and Laura Alder, MD, treat a high volume of patients with SCLC.

“At Duke, we are fortunate to have a multidisciplinary team that is all highly experienced with SCLC, including medical oncology, radiation oncology, thoracic surgery, radiology, and interventional pulmonology. In addition, Duke offers cutting-edge treatments, including multiple clinical trials. Clinical trials give patients the opportunity to get new, exciting treatments that hold a lot of promise,” Alder says. 

According to Bevers, SCLC historically has not seen the same level of research progress or novel treatment development as non-small cell lung cancer (NSCLC), but DCI is focused on changing that. “We have clinical trials for every type of lung cancer, including small cell, and for various stages of the disease — from early-stage diagnosis to later-stage metastatic disease,” she says. “We want to move the field forward and change the current standards of care, so we’re looking ahead and bringing exciting new treatments to the forefront.”

A key strength of the SCLC program at DCI is its focus on translational research. Bevers, a thoracic surgeon, and Alder, a medical oncologist, work closely with Trudy G. Oliver, PhD, a world-renowned SCLC researcher, advancing the understanding of SCLC biology. Oliver’s lab investigates mechanisms of tumor cell fate, lineage plasticity, and drug resistance to uncover vulnerabilities that can be targeted with therapies.

Oliver and her team are advancing laboratory discoveries into clinical practice by evaluating novel treatments that show promise in human model studies. “Dr. Oliver is a leading scientist in the field of SCLC, and with her collaboration, we are confident this work will translate into more treatment options and better outcomes for our patients,” Alder says.

As a thoracic surgeon, Bevers highlights DCI’s unique surgical approach to treating SCLC. “Small cell lung cancers are often diagnosed at later stages and metastasize quickly and aggressively, so many centers will not operate on them,” Bevers says. “At Duke, we review every case in a multidisciplinary conference and determine, as a group, whether surgical intervention — often in combination with other therapies — may be an option.”

Duke’s approach is guided by clinical research using national databases to evaluate the effectiveness of surgical interventions for SCLC.

“There’s evidence that removing advanced tumors, even with lymph node involvement, can improve survival rates,” Bevers says. “We’re uniquely performing aggressive surgical procedures for small cell lung cancer to achieve better outcomes.”

Another distinctive aspect of Duke’s multidisciplinary care model is its collaboration with the Duke Center for Brain and Spine Metastasis (DCBSM). Here, a subset of medical oncologists, radiation oncologists, neurosurgeons, and spine surgeons strives to deliver the best outcomes for patients with cancer that has spread to the central nervous system (CNS). Alder serves as DCBSM’s deputy medical director. 

“More than 50% of SCLC will involve the CNS, which includes the brain, spine, and fluid surrounding the brain,” Alder says. “The DCBSM is closely integrated into the care we deliver. This allows expert care for these patients, and additional clinical trials that focus on optimizing outcomes in the CNS as well as the rest of the body.” 

Ann Marie Pendergast, PhD, a distinguished cancer biology researcher at DCI, is also advancing research to identify tumor biology targets that can guide treatment decisions. Using human SCLC cell lines and mouse models, Pendergast’s lab discovered that targeting ABL tyrosine kinases significantly reduces SCLC growth and viability across multiple subtypes. The team also identified metabolic and replication stress pathways that, when combined with ABL kinase allosteric inhibitors, may work together to kill metastatic and therapy-resistant SCLC cells.

“We want community physicians to know that we are a high-volume center offering leading-edge therapies and clinical trials for small cell lung cancer,” Bevers says. “At any stage of disease, we are happy to consult on cases, provide second opinions, and work collaboratively with referring physicians to develop treatment plans.”