4.6 Review

First-Line Treatment for Advanced SCLC: What Is Left Behind and Beyond Chemoimmunotherapy

Journal

FRONTIERS IN MEDICINE
Volume 9, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fmed.2022.924853

Keywords

small cell lung cancer (SCLC); immunotherapy; chemotherapy; biomarkers; first-line therapy

Funding

  1. FPRC 5xmille Ministero Salute 2017 PTCRC-Intra 2020 CTU-Lung
  2. Italian Ministry of Health

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This review discusses the survival benefit of adding immune checkpoint inhibitors to first-line standard chemotherapy in advanced SCLC patients, based on the data from three phase III randomized clinical trials. It also analyzes unresolved issues and the future of SCLC first-line therapy management.
Small cell lung cancer (SCLC) is still a lethal disease. Three phase III randomized clinical trials (IMpower133, CASPIAN, and KEYNOTE-604) have highlighted the survival gain of adding immune checkpoint inhibitors to first-line standard chemotherapy in advanced SCLC patients. In this review, we discuss the data from the three trials above. Furtherly, we analyze issues that still need to be elucidated, like the role of biomarkers, poor performance status at baseline, the presence of brain metastases, and the platinum compound's choice. Moreover, we depict the future of SCLC first-line therapy management, focusing on new therapeutic strategies currently under investigation.

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