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Review
. 2021 Jun;10(6):2970-2987.
doi: 10.21037/tlcr-20-630.

Immunotherapy in small cell lung cancer: one step at a time: a narrative review

Daphne W Dumoulin  1 , Anne-Marie C Dingemans  1   2 , Joachim G J V Aerts  1 , Jordi Remon  3 , Dirk K M De Ruysscher  4 , Lizza E L Hendriks  2
Affiliations
Review

Immunotherapy in small cell lung cancer: one step at a time: a narrative review

Daphne W Dumoulin et al. Transl Lung Cancer Res. 2021 Jun.

Abstract

Chemotherapy with or without radiotherapy has been the standard of care for many years for patients with small cell lung cancer (SCLC). Despite exceptionally high responses (up to 80%) with chemotherapy, the majority of patients relapse rapidly within weeks to months after treatment completion. Therefore, new and better treatment options are necessary. Recently, synergistic activity has been reported for the addition of immune checkpoint inhibitors (ICI) to standard platinum-based chemotherapy in the therapeutic strategy of advanced SCLC. For the first time after several decades, a significant survival improvement was achieved for this population. However, the overwhelming majority of patients do not respond to ICI, or relapse rapidly. There is need for better knowledge about the biology, histopathologic features, and molecular pathways of SCLC. This can probably help to identify the optimal predictive biomarkers, which are warranted to develop an individual therapeutic strategy including the rational use of a combination of immunotherapeutic agents. Here, we provide an overview of the rationale for and clinical results of the completed and ongoing trials using different strategies of immunotherapy in SCLC. In addition, opportunities for further improvement of therapies will be discussed, including the addition of radiotherapy, co-stimulatory antibodies, and other immune modifying agents.

Keywords: Small cell lung cancer (SCLC); checkpoint inhibition; immunotherapy.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tlcr-20-630). The series “Immunotherapy in other thoracic malignancies and uncommon populations” was commissioned by the editorial office without any funding or sponsorship. JGJV Aerts serves as an unpaid editorial board member of Translational Lung Cancer Research from Sep 2019 to Sep 2021. JR served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Translational Lung Cancer Research from Sep 2019 to Sep 2021. DD reports personal fees from Roche, personal fees from BMS, personal fees from MSD, personal fees from Pfizer, personal fees from Astra Zeneca, personal fees from Novartis, outside the submitted work. AMD reports other from Roche, other from BOEHRINGER, other from Pharmamar, other from Pfizer, other from Takeda, grants and other from BMS, other from Lilly, grants from Abbvie, outside the submitted work. JGJVA reports personal fees and non-financial support from msd, personal fees from bms, personal fees from boehringer ingelheim, personal fees from amphera, personal fees from eli-lilly, personal fees from takeda, personal fees from bayer, personal fees from roche, personal fees from astra zeneca, outside the submitted work; In addition, Dr. JGJVA has a patent allogenic tumor cell lysate licensed to amphera, a patent combination immunotherapy in cancer pending, and a patent biomarker for immunotherapy pending. JR reports other from MSD, other from Boehringer, other from Pfizer, personal fees and other from Ose Immunotherapeutics, other from BMS, other from AstraZeneca, other from Roche, outside the submitted work. DDR reports grants from Boehringer, other from Celgene, grants and other from BMS, other from Pfizer, other from Roche, grants and other from AstraZeneca, other from MSD, other from Seattle genetics, grants from Philips, grants from Olink, outside the submitted work. LH reports grants and other from Roche, grants and other from Boehringer, grants from AstraZeneca, other from BMS, other from Eli Lilly, other from Pfizer, other from Takeda, other from MSD, from null, outside the submitted work. The authors have no other conflicts of interest to declare.

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