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Review
. 2025 Jun;6(6):954-966.
doi: 10.1038/s43018-025-00992-5. Epub 2025 Jun 5.

The current and emerging immunotherapy paradigm in small-cell lung cancer

Kang Qin #  1 , Carl M Gay #  1 , Lauren A Byers  2 , Jianjun Zhang  3
Affiliations
Review

The current and emerging immunotherapy paradigm in small-cell lung cancer

Kang Qin et al. Nat Cancer. 2025 Jun.

Abstract

Small-cell lung cancer (SCLC) is a highly aggressive malignancy with poor prognosis. For decades, etoposide-platinum-based chemotherapy had been the mainstay treatment for SCLC; however, despite initial high response rates, most patients developed resistance. In 2019, the US Food and Drug Administration approved the anti-PD-L1 antibody atezolizumab in combination with etoposide-platinum as the new first-line standard of care for extensive-stage SCLC, heralding a paradigm shift in SCLC therapy. This Review aims to provide an overview of the current landscape and emerging treatment strategies of immunotherapies in SCLC as well as highlight the importance of developing biomarkers to facilitate patient selection.

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Conflict of interest statement

Competing interests: C.M.G. serves on advisory committees for Abdera, AstraZeneca, BMS, Daiichi Sankyo, G1, Jazz, MonteRosa, Roche/Genentech and reports Speaking Engagement from AstraZeneca, BeiGene, MJH, OncLive, PeerView, Targeted Healthcare, and receives Paid Consulting from Catalyst, Kisoji, STCube. L.A.B. serves on advisory committees for AstraZeneca, AbbVie, Genetech, Amgen, Daiichi Sankyo, Novartis and has research support from AstraZeneca, Amgen. J.Z. reports grants from Merck and Helius, grants and personal fees from Johnson and Johnson and Novartis, personal fees from Bristol-Myers Squibb, AstraZeneca, GenePlus, Innovent, Varian, Catalyst and Hengrui outside the submitted work. K.G. declares no competing interests.

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