Extensive-Stage Small-Cell Lung Cancer: Current Landscape and Future Prospects

Abstract

Small-cell lung cancer (SCLC) is characterized by aggressive disease progression and tendency to metastasize. Although chemotherapy for extensive-stage SCLC (ES-SCLC) has remained unchanged for decades, immune checkpoint inhibitors have become the primary therapy for ES-SCLC. However, the number of patients benefiting from immunotherapy is limited, and the treatment outcomes remain unsatisfactory. In addition, predictive biomarkers for immunotherapy have not yet been identified. Recent reports have shed light on the genomics of SCLC and defined four distinct molecular subtypes based on transcription factor expression. This may increase our understanding of the biology of SCLC and identify novel therapeutic targets and drugs. In this article, we review the current standard management of ES-SCLC and present the most recent reports to further our understanding of molecular classification, predictive biomarkers, and prospective therapies, including immunotherapy, chemotherapy, and targeted therapy.

Keywords:

• small-cell lung cancer
• extensive-stage
• immunotherapy
• targeted therapy

Disclosure

Dr Satoshi Watanabe reports grants and/or personal fees from Boehringer Ingelheim, Lilly, Pfizer, Novartis Pharma, AstraZeneca, Chugai Pharma, Bristol-Myers, Ono Pharmaceutical, Daiichi Sankyo, Taiho Pharmaceutical, Nippon Kayaku, outside the submitted work. Dr Toshiaki Kikuchi reports grants, non-financial support from Nobelpharma; grants and/or personal fees from Boehringer Ingelheim, Taiho Pharmaceutical, KYORIN Pharmaceutical, Shionogi, Chugai Pharma, Asahi Kasei, Daiichi Sankyo, Nippon Kayaku, TEIJIN PHARMA, AN2 Therapeutics, Viatris, Astellas Pharma, Insmed, Terumo, Eli Lilly, AstraZeneca, Novartis, Merck, Bristol-Myers, NIPRO, Eisai, Ono Pharmaceutical, GSK, Sumitomo Pharma, Kyowa Kirin, MSD, Sanofi, Meiji Seika Pharma, and Janssen Pharmaceutical, outside the submitted work. The authors declare that they have no other competing interests in this work.