Role of Immunotherapy for Small Cell Lung Cancer

Furkan CEYLANa , Mehmet Ali Nahit ŞENDURb
aAnkara Bilkent City Hospital, Clinic of Medical Oncology, Ankara, Türkiye
bAnkara Yıldırım Beyazıt University Faculty of Medicine, Ankara Bilkent City Hospital, Department of Medical Oncology, Ankara, Türkiye

Ceylan F, Şendur MAN. Role of immunotherapy for small cell lung cancer. In: Şendur MAN, ed. Current Immunotherapy Landscape for Solid Tumors. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.44-51.

ABSTRACT
Small-cell lung cancer (SCLC) account for approximately 14% of lung cancers. It was almost 100% associated with smoking. SCLC is a tumor with a short doubling time, therefore it grows rapidly and metastases develop early. For many years, the standard treatment for limited stage (LS) disease has been a combination of radiotherapy and doublet chemotherapy containing platinum salts. There are no phase 3 clinical studies in which ICIs have demonstrated a survival benefit. Clinical trials evaluating the efficacy of ICIs are ongoing in LS-SCLC. Chemotherapy forms the basis of advanced disease treatment. Addition of atezolizumab to chemotherapy in the Impower 133 trial, adding durvalumab to chemotherapy in the CASPIAN trial and adding serplulimab to chemotherapy in ASTRUM 005 trial has shown a survival benefit in first-line. ICIs may be appropriate for some patient groups in relapsed disease. The efficacy of nivolumab has been demonstrated in the second line of patients who are not suitable for chemotherapy. Nivolumab has been shown to provide a survival benefit in patients who have received at least two lines of therapy. Long duration of Response (DoR) has been shown to be obtained in PD-L1-positive patients who have received at least two lines of therapy and who achieved an objective response with pembrolizumab. While cytotoxic chemotherapy still serves as the cornerstone of disease care, significant progress is being made in the management of SCLC by creating new drugs, testing innovative combinations, and personalizing treatment.

Keywords: Small cell lung carcinoma; immunotherapy; atezolizumab; durvalumab; immune checkpoint inhibitors

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