Second-line Treatment in Patients With Small Cell Lung Cancer (SCLC)

Inclusion Criteria:

* Small-cell lung cancer.
* Patients who, after (at least) a first line of chemotherapy based on platinum, had a partial response and then progressed, or who had a complete response and then relapsed within three months following the last course of this first-line therapy.
* Measurable or assessable disease.
* Life expectancy \>2 months.
* Patients with a therapeutic risk level of \<5 points (see section 6: "Treatment flowchart").
* Age \>18 years;
* Performance status (WHO) \<2;
* One measurable target lesion in a non irradiated region;
* Prior radiotherapy authorized unless it targeted the only measurable lesion;
* Biological criteria: WBC \>2000/mm3, PMN \>1500/mm3, platelets \>100 000/mm3, creatinemia \<2 x ULN, bilirubinemia \<ULN, ALT and AST \<2.5 x ULN (\< 5 N if liver metastases)
* normal ECG
* written informed consent.

Exclusion Criteria:

* Non small-cell lung cancer.
* No objective response to platinum-based therapy
* Complete response lasting more than three months after the last course of first-line treatment.
* Symptomatic brain metastases.
* Bone metastases, carcinomatous lymphangitis, ascites or pleurisy as sole assessable disease manifestations.- Concurrent participation in another clinical trial.
* Therapeutic risk level of 6 points or more (see table)
* Uncontrolled clotting disorders;
* Uncontrolled severe infection;
* History of another malignancy, except for cervical carcinoma in situ or basocellular cancer that are considered cured;
* Psychological, familial, sociological or geographic circumstances preventing treatment follow-up as defined in the protocol;
* Patients deprived of their rights for administrative or legal reasons.