Extensive-Stage Small-Cell Lung Cancer: First-Line and Second-Line Treatment Options

• Published in: Journal of clinical oncology Vol. 40; no. 6; pp. 671 - 680
• Main Authors: Zugazagoitia, Jon, Paz-Ares, Luis
• Format: Journal Article
• Language: English
• Published: United States 20-02-2022
• Subjects: Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Humans; Immune Checkpoint Inhibitors - adverse effects; Immune Checkpoint Inhibitors - therapeutic use; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Molecular Targeted Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; Small Cell Lung Carcinoma - mortality; Small Cell Lung Carcinoma - pathology; Small Cell Lung Carcinoma - therapy; Treatment Outcome
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/jco.21.01881

Extensive-stage small-cell lung cancer is a therapeutically challenging disease. After more than two decades without clinical progress, the addition of programmed cell death protein 1 axis blockade to platinum-based chemotherapy has demonstrated sustained overall survival benefit and represents the current standard of care in the first-line setting. Despite this benefit, resistance emerges relatively rapidly in virtually all patients. Although newer treatments are being incorporated in the relapse setting, marked therapeutic resistance is typically observed in patients with relapsed small-cell lung cancer (SCLC), underscoring the need of developing more effective therapies in this setting. Notably, recent progress in the understanding of the molecular biology of SCLC might bring possibilities toward molecularly informed therapeutic strategies for patients with SCLC, which could have a significant impact for improving outcomes in this disease. Here, we review current treatment options and recent progress made in the first-line and relapsed SCLC, including the role of biomarkers and new evolving therapeutic strategies.