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Third line chemo?


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My mom (63, diagnosed SCLC extensive in April) went through six cycles of Cisplatin/Etoposide with great results but quickly relapsed. She just finished her second cycle of Topotecan, but her cell counts are tanking and she's terribly weak, so the onc canceled the third and ordered up radiation to shrink the main tumor in her chest -- which is causing breathing, swallowing and talking problems. He said that after radiation -- probably two weeks worth -- she'll come back and they'll talk about chemo options.

I'm wondering, what could the options be after Cisplatin/Etoposide and then Topotecan? I haven't really seen anyone with small cell talk about other therapies and I can't find much on the 'Net. Seems like most of the second- and third-line drugs being developed are for NSCLC. Do patients sometimes return to a platinum-based chemo, even if they developed resistance to it earlier?

My understanding is that radiation is essentially palliative with small cell, so I'm very focused on what my mom can do next to kill off the cells systemically.

Any guidance much appreciated...

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