Current Treatment Paradigm: Evolution of First-Line Therapy for ES-SCLC
Panelists discuss how the addition of immune checkpoint inhibitors to first-line chemotherapy has transformed the treatment of extensive-stage small cell lung cancer, improving survival while highlighting ongoing challenges in managing relapse and the need for continued research into novel therapies.
Summary for Physicians:
The treatment landscape for extensive-stage small cell lung cancer (ES-SCLC) has evolved significantly over the past decade.
Historically, platinum-based chemotherapy (typically etoposide with either cisplatin or carboplatin) was the standard of care, offering initial high response rates but limited durability due to rapid disease progression and high relapse rates.
In recent years, the addition of immune checkpoint inhibitors to first-line chemotherapy has changed the standard approach. The combination of chemotherapy with PD-L1 inhibitors (e.g., atezolizumab or durvalumab) has demonstrated improved overall survival and is now considered the first-line standard of care for most patients with ES-SCLC.
Despite these advances, challenges remain, particularly in managing disease recurrence, for which options are limited. Research is ongoing into novel immunotherapy combinations, targeted agents, and biomarkers to further improve outcomes in this aggressive disease.
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