
Given the unprecedented success of programmed death 1 (PD-1) antagonists in the treatment of advanced non–small-cell lung cancer (NSCLC), both in the first- and second-line settings, exploring their role in small-cell lung cancer (SCLC) has been a logical next step.
In this disease, therapeutic outcomes have changed little during the past two decades. In particular, patients who have experienced relapse face a grim outcome, with median survival times of approximately 6 months after treatment with the only approved drug, topotecan, and few patients alive at 1 year.
Efforts to improve this outcome by employing cytotoxic therapies—to a large extent—have failed, with the notable exception of a recent Japanese phase III trial that identified a combination regimen that consists of cisplatin, etoposide, and irinotecan as carrying superior survival outcomes compared with topotecan; however, toxicity associated with this combination is prohibitive and has generated little enthusiasm outside of Japan where irinotecan—as a result of negative phase III studies—has no role in the therapeutic armentarium of SCLC.
Source: Journal of Clinical Oncology







