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Review
. 2022 May 25:9:924853.
doi: 10.3389/fmed.2022.924853. eCollection 2022.

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

Emilio Francesco Giunta  1 , Alfredo Addeo  2 , Alessio Rizzo  3 , Giuseppe Luigi Banna  1
Affiliations
Review

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

Emilio Francesco Giunta et al. Front Med (Lausanne). .

Abstract

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.

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

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Conflict of interest statement

GLB reports personal fees from Janssen Cilag, Boehringer Ingelheim, and Roche. AA reports personal fees from BMS, Astrazeneca, Roche, Pfizer, MSD, Boehringer. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Clinical practical questions and current answers about first-line chemoimmunotherapy for extensive-stage small-cell-lung cancer. chemo-IO, chemoimmunotherapy; ECOG PS, Eastern Cooperative Oncology Group Performance Statis; mets, metastases; PCI, prophylactic cranial irradiation; PD-L1, programmed cell death ligand-1; TMB, tumor mutational burden.
See this image and copyright information in PMC

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