The standard of care for patients with small cell lung cancer (SCLC) has been trapped in a period of stagnation for the past several decades. However, meaningful improvements in outcomes with immunotherapy in recent years are finally starting to change the tide for the first-line treatment of these patients.

“Over the past 30 to 40 years, over 60 active agents have been tried with improvements in response rate and progression-free survival, but no improvement in overall survival,” Benjamin P. Levy, MD, said in a presentation at the 17th Annual Winter Lung Cancer Conference®, hosted by Physicians’ Education Resource®, LLC. “This has historically [been an] aggressive disease with disappointing results. Immunotherapy clearly has been transformative in non–small cell lung cancer; it is the standard of care for most patients without a driver mutation in the first-line in combination with platinum chemotherapy and we see efficacy across various tumor types.”

SCLC has the characteristics of a disease that would be “ripe for the taking” with immunotherapy, Levy, an assistant professor of oncology and clinical director of Medical Oncology at Sidney Kimmel Cancer Center of Johns Hopkins Medicine, said during the meeting.According to a prospective study of patients with extensive-stage (ES) SCLC (n = 432), 93% received first-line therapy, 50% received second-line therapy, and 22% received third-line therapy.2 

“Few patients receive third-line therapy,” Levy said. “I do not think that immunotherapy is going to play a meaningful role as a third-line [option] for these patients.”

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