Emerging treatments
Pembrolizumab
The KEYNOTE-604 trial investigated the use of the checkpoint inhibitor pembrolizumab or placebo, plus etoposide and platinum chemotherapy, as first-line treatment for extensive-stage SCLC. Pembrolizumab plus etoposide and platinum chemotherapy significantly improved progression-free survival, compared with placebo plus etoposide and platinum chemotherapy.[73]
Adebrelimab
In patients with extensive-stage small-cell lung cancer (ES-SCLC), adebrelimab plus etoposide and carboplatin significantly improved overall survival compared with placebo plus etoposide and carboplatin.[74]
Toripalimab
The PD-1 inhibitor toripalimab has been granted orphan drug designation for SCLC in the US. JUPITER-08 is an ongoing study that is evaluating toripalimab in combination with chemotherapy (cisplatin or carboplatin plus etoposide), compared with placebo in combination with chemotherapy, as a first-line treatment of extensive-stage SCLC.[75]
Serplulimab
The PD-1 inhibitor serplulimab has been granted orphan drug designation for SCLC in the US. In the ASTRUM-005 trial, first-line treatment with serplulimab plus chemotherapy in patients with extensive-stage SCLC resulted in improved overall survival compared with chemotherapy alone.[76]
Stereotactic radiosurgery
Stereotactic radiosurgery has superseded whole brain radiation therapy (WBRT) as the first-line treatment for intracranial metastatic disease in most solid cancers. However, WBRT remains the first-line treatment for intracranial metastatic disease in patients with SCLC. One meta-analysis has shown that survival outcomes are similar following treatment with SRS, compared with WBRT, in patients with SCLC and intracranial metastatic disease.[77]
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