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Dashing Decades of Defeat: Long Anticipated Advances in the First-line Treatment of Extensive-Stage Small Cell Lung Cancer

  • Lung Cancer (H Borghaei, Section Editor)
  • Published:
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Abstract

Purpose of Review

Small cell lung cancer (SCLC) is an exceptionally lethal subtype of lung cancer. For patients with extensive-stage (ES) disease, which is the majority of patients, platinum-doublet chemotherapy has been the standard of care for decades. Dozens of phase III trials have failed to improve survival over standard platinum plus etoposide. Recent results, however, have met with long-overdue success. This manuscript reviews the new standards of care for ES-SCLC.

Recent Findings

Two recent phase III trials have shown an improvement in overall survival with concurrent immunotherapy and chemotherapy. In IMpower 133, the addition of the anti-PD-L1 antibody atezolizumab to carboplatin plus etoposide significantly improved both progression-free survival (PFS) and overall survival (OS). This was the first trial in over 30 years to improve survival. In CASPIAN, concurrent durvalumab, another anti-PD-L1 antibody, also led to an improvement in survival.

Summary

While there is clearly a need to further improve outcomes, the improvement in survival with the addition of atezolizumab or durvalumab to platinum-doublet chemotherapy is a major advance. We now have new standards of care and the potential of a more meaningful benefit for patients with advanced SCLC.

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  1. Lombardi Comprehensive Cancer Center, Georgetown University, 3800 Reservoir Road NW, Washington, DC, 20007, USA

    Samantha A. Armstrong & Stephen V. Liu

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Samantha A. Armstrong declares that she has no conflict of interest.

Stephen V. Liu has received research funding from Alkermes, AstraZeneca, Bayer, Blueprint Medicines, Bristol-Myers Squibb, Clovis Oncology, Corvus Pharmaceuticals, Debiopharm, Esanex, Genentech/Roche, Eli Lilly, Lycera, Merck/MSD, Merus, Molecular Partners, Pfizer, Rain Therapeutics, RAPT Therapeutics, Spectrum, Takeda/ARIAD, Turning Point Therapeutics, and Ignyta; has received compensation from Apollomics, AstraZeneca, Bristol-Myers Squibb, Celgene, G1 Therapeutics, Genentech/Roche, Guardant Health, Janssen, Eli Lilly, Loxo Oncology, Merck/MSD, Pfizer, PharmaMar, S.A., Regeneron Pharmaceuticals, Taiho Oncology, Takeda/ARIAD, Ignyta, and Tempus; and has received non-financial support from AstraZeneca, Genentech/Roche, and Merck/MSD.

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Armstrong, S.A., Liu, S.V. Dashing Decades of Defeat: Long Anticipated Advances in the First-line Treatment of Extensive-Stage Small Cell Lung Cancer. Curr Oncol Rep 22, 20 (2020). https://doi.org/10.1007/s11912-020-0887-y

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