Extensive-Stage Small-Cell Lung Cancer: First-Line and Second-Line Treatment Options.

Extensive-stage small-cell lung cancer is a therapeutically challenging disease. After more than two decades without clinical progress, the addition of programmed cell death protein 1 axis blockade to platinum-based chemotherapy has demonstrated sustained overall survival benefit and represents the current standard of care in the first-line setting. Despite this benefit, resistance emerges relatively rapidly in virtually all patients. Although newer treatments are being incorporated in the relapse setting, marked therapeutic resistance is typically observed in patients with relapsed small-cell lung cancer (SCLC), underscoring the need of developing more effective therapies in this setting. Notably, recent progress in the understanding of the molecular biology of SCLC might bring possibilities toward molecularly informed therapeutic strategies for patients with SCLC, which could have a significant impact for improving outcomes in this disease. Here, we review current treatment options and recent progress made in the first-line and relapsed SCLC, including the role of biomarkers and new evolving therapeutic strategies.
Competing Interests: Jon ZugazagoitiaHonoraria: AstraZeneca Spain, Bristol Myers Squibb/Celgene, Pfizer, Roche/Genentech, NanoString Technologies, Guardant HealthConsulting or Advisory Role: AstraZeneca, Pfizer, Bristol Myers Squibb/Celgene, Novartis, Novartis, Guardant HealthSpeakers' Bureau: Bristol Myers Squibb/Celgene, Pfizer, Roche, MSD Oncology, AstraZeneca, NanoString Technologies, Guardant HealthResearch Funding: AstraZeneca (Inst), Roche/Genentech (Inst)Travel, Accommodations, Expenses: Bristol Myers Squibb/Celgene, Roche/Genentech Luis Paz-AresLeadership: Genomica, ALTUM SequencingHonoraria: Roche/Genentech, Lilly, Pfizer, Bristol Myers Squibb, MSD, AstraZeneca, Merck Serono, PharmaMar, Novartis, Celgene, Amgen, Sanofi, Ipsen, Servier, Bayer, Blueprint Medicines, Takeda, Mirati Therapeutics, Daiichi SankyoSpeakers' Bureau: MSD Oncology, BMS, Roche/Genentech, Pfizer, Lilly, AstraZeneca, Merck SeronoResearch Funding: BMS (Inst), AstraZeneca (Inst), PharmaMar (Inst), Kura Oncology (Inst), MSD (Inst), Pfizer (Inst)Travel, Accommodations, Expenses: Roche, AstraZeneca, MSD, Bristol Myers Squibb, Pfizer, TakedaOther Relationship: Novartis, Ipsen, Pfizer, Servier, Sanofi, Roche, Amgen, Merck, RocheNo other potential conflicts of interest were reported.