Immunotherapy for extensive-stage small-cell lung cancer: current landscape and future perspectives

Abstract

Small-cell lung cancer (SCLC) is a fatal subtype of lung cancer characterized by high aggressiveness, poor prognosis, and limited treatment options. For the first time in more than three decades, it has been demonstrated that the addition of immunotherapy to chemotherapy improved the survival of patients with extensive-stage SCLC, thereby immunotherapy plus chemotherapy established a new standard of first-line treatment. However, it is important to improve the curative effect of immunotherapy on SCLC and identify the patients who could benefit from such treatment. In this article, we review the current status of the first-line immunotherapy, the strategies to improve the efficacy of immunotherapy and the discovery of potential predictive biomarkers of immunotherapy for SCLC.

Promises of Protein Kinase Inhibitors in Recalcitrant Small-Cell Lung Cancer: Recent Scenario and Future Possibilities

“…The findings of this study suggest that the inclusion of Atezolizumab alongside chemotherapy as a primary treatment for ES-SCLC led to a modest increase of 2 months in OS and 0.9 months in progression-free survival (PFS) compared to chemotherapy alone. This trial is a significant milestone, as it provides the initial evidence of the therapeutic advantage associated with PD-L1 inhibitors in individuals diagnosed with ES-SCLC, albeit with only a modest effect size [ 57 ]. The randomized distribution of patients without the knowledge of drug target levels might be a reason for the limited clinical response observed in IMpower133 [ 10 , 11 , 12 , 13 ].…”

Effects of KEAP1 Silencing on NRF2 and NOTCH Pathways in SCLC Cell Lines

“…Most recently, a large number of studies have shown promising antitumor activity from first-line immunotherapy drugs plus platinum-based chemotherapy. This has resulted in a significant improvement in SCLC patients with extensive disease in terms of diseasefree survival (PFS) and overall survival (OS) versus chemotherapy alone [6][7][8].…”

Can liquid biopsy dynamics stratify patients with small cell lung cancer?

“…Stage IV SCLC is an advanced and aggressive form of lung cancer characterized by rapid growth, early metastasis, treatment resistance and disease recurrence, resulting in a poor prognosis for patients ( 3 ). Platinum-etoposide chemotherapy was the standard first-line treatment for extensive-stage SCLC (ES-SCLC) for several decades; however, the need for additional treatment strategies remained ( 3 , 4 ). After decades of little progress, immune checkpoint inhibitors (ICI) revolutionized the treatment landscape, leading to a new standard of care in the first-line setting ( 3 - 6 ).…”