Current trends in small cell lung cancer management—ASCO 2019 update

  • Mircea DediuEmail author
short review


During the last 30 years the developments in small cell lung cancer (SCLC) have been extremely scarce. Concurrent chemo-radiation associated with prophylactic cranial irradiation in case of complete clinical remission is standard in limited disease. In extensive disease, platinum/etoposide and topotecan remain the standard systemic approaches in the first- and second-line setting, respectively. The only notable improvement was communicated in the IMpower133 trial, by the addition of atezolizumab to the platinum/etoposide chemotherapy backbone. Against this background, the current article aims to review the most important abstracts presented at ASCO 2019 along with their potential impact for current clinical practice.


SCLC Management ASCO 2019 


Conflict of interest

M. Dediu served as consultant and received speaker honoraria from: Boehringer-Ingelheim, Roche, Novartis, MSD, Astra-Zeneca, Bristol-Myers Squibb, Ipsen, Sandoz, Pfizer, Astellas, Merck.


  1. 1.
    Aupérin A, Arriagada R, Pignon JP, Le Péchoux C, Gregor A, Stephens RJ, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med. 1999;341(7):476–84.CrossRefGoogle Scholar
  2. 2.
    Slotman BJ, van Tinteren H, Praag JO, Knegjens JL, El Sharouni SY, Hatton M, et al. Use of thoracic radiotherapy for extensive stage small cell lung cancer:a phase 3 randomized controlled trial. Lancet. 2015;385(9962):36–42.CrossRefGoogle Scholar
  3. 3.
    Evans WK, Shepherd FA, Feld R, Osoba D, Dang P, Deboer G. VP-16 and cisplatin as first line therapy for small cell lung cancer. J Clin Oncol. 1985;3(11):1471–7.CrossRefGoogle Scholar
  4. 4.
  5. 5.
    Horn L, Mansfield AS, Szczęsna A, Havel L, Krzakowski M, Hochmair MJ, et al. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med. 2018;379(23):2220–9.CrossRefGoogle Scholar
  6. 6.
    Ardizzoni A, Hansen H, Dombernowsky P, Gamucci T, Kaplan S, Postmus P, et al. Topotecan, a new active drug in the second-line treatment of small-cell lung cancer: a phase II study in patients with refractory and sensitive disease. The European Organization for Research and Treatment of Cancer Early Clinical Studies Group and New Drug Development Office, and the Lung Cancer Cooperative Group. J Clin Oncol. 1997;15(5):2090–6.CrossRefGoogle Scholar
  7. 7.
    von Pawel J, Schiller JH, Shepherd FA, Fields SZ, Kleisbauer JP, Chrysson NG, et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol. 1999;17(2):658–67.CrossRefGoogle Scholar
  8. 8.
    von Pawel J, Jotte R, Spigel DR, O’Brien ME, Socinski MA, Mezger J, et al. Randomized phase III trial of amrubicin versus topotecan as second-line treatment for patients with small-cell lung cancer. J Clin Oncol. 2014;32(35):4012–9.CrossRefGoogle Scholar
  9. 9.
    Reck M, Vicente D, Ciuleanu T, Gettinger S, Peters S, Horn LReck M, et al. Efficacy and safety of nivolumab (nivo) monotherapy versus chemotherapy (chemo) in recurrent small cell lung cancer (SCLC): Results from CheckMate 331. Ann Oncol. 2018;29(suppl_10):x39–x43. Scholar
  10. 10.
    Paz-Ares L, Perez J, Besse B, Moreno V, Lopez R, Sala, et al. Efficacy and safety profile of lurbinectedin in second-line SCLC patients: Results from a phase II single-agent trial. J Clin Oncol. 2019;37(suppl):abstr 8506.Google Scholar
  11. 11.
    George J, Lim JS, Jang SJ, Cun Y, Ozretić L, Kong G, et al. Comprehensive genomic profiles of small cell lung cancer. Nature. 2015;524(7536):47–53.CrossRefGoogle Scholar
  12. 12.
    Hart L, Andric Z, Hussein M, Ferrarotto R, Beck T, Subramanian J, et al. Effect of trilaciclib, a CDK 4/6 inhibitor, on myelosuppression in patients with previously treated extensive-stage small cell lung cancer receiving topotecan. J Clin Oncol. 2019;37(suppl):abstr 8505.Google Scholar
  13. 13.
    Dragnev K, Owonikoko T, Csoszi T, Maglakelidze M, Bec JT, Gomez, et al. Trilaciclib (T) decreases multi-lineage myelosuppression in extensive-stage small cell lung cancer (ES-SCLC) patients receiving 1st line chemotherapy. Ann Oncol. 2018;29(suppl_8):viii596–viii602.CrossRefGoogle Scholar
  14. 14.
    Owonikoko T, Higgins K, Chen Z, Zhang C, Pillai R, Steuer CE, et al. A randomized phase II study of tremelimumab and durvalumab with or without radiation for patients with relapsed small cell lung cancer (SCLC). J Clin Oncol. 2019;37(suppl):abstr 8515.Google Scholar
  15. 15.
    Malhotra J, Nikolinakos P, Leal T, Lehman J, Morgensztern D, Patel J, et al. Ph1/2 study of Rova‑T in combination with nivolumab (Nivo) ± ipilimumab (Ipi) for patients (pts) with 2L+ extensive-stage (ED) SCLC. J Clin Oncol. 2019;37(suppl):abstr 8516.Google Scholar
  16. 16.
    Carbone D, Morgensztern D, Le Moulec S, Santana-Davila R, Ready N, Hann C, et al. Efficacy and safety of rovalpituzumab tesirine (Rova-TTM) in patients with DLL3-expressing, ≥3rd line small cell lung cancer: results from the phase 2 TRINITY study. J Clin Oncol. 2018;36(suppl):abstr 8507.CrossRefGoogle Scholar
  17. 17.
    Sakre N, Wildey G, Behtaj M, Kresak A, Yang M, Fu P, et al. RICTOR amplification identifies a subgroup in small cell lung cancer and predicts response to drugs targeting mTOR. Oncotarget. 2017;8(4):5992–6002.CrossRefGoogle Scholar
  18. 18.
    Park S, Shim J, Jung H, Sun JM, Lee SH, Park WY, et al. Biomarker driven phase II umbrella trial study of AZD1775, AZD2014, AZD2811 monotherapy in relapsed small cell lung cancer. J Clin Oncol. 2019;37(suppl):abstr 8514.Google Scholar
  19. 19.
    Owonikoko TK, Kim HR, Govindan R, Ready N, M. Reck M, Peters S, et al. Nivolumab (nivo) plus ipilimumab (ipi), nivo, or placebo (pbo) as maintenance therapy in patients (pts) with extensive disease small cell lung cancer (ED-SCLC) after first-line (1L) platinum-based chemotherapy (chemo): Results from the double-blind, randomized phase III CheckMate 451 study. Presented at: 2019 European Lung Cancer Congress; April 11 to 13, 2019; Geneva, Switzerland. Abstract LBA1.Google Scholar
  20. 20.
    Ready N, Farago AF, de Braud F, Atmaca A, Hellmann MD, Schneider, et al. Third-line nivolumab monotherapy in recurrent SCLC: checkmate 032. J Thorac Oncol. 2019;14(2):237–44.CrossRefGoogle Scholar
  21. 21.
    Phase 3 Trial of Rova‑T as Second-line Therapy for Advanced Small-Cell Lung Cancer (TAHOE Study) Halted. AbbVie. Published December 5, 2018. Accessed December 6, 2018.

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Sanador Oncology CenterBucharestRomania

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