Advances in systemic treatment of small-cell lung cancer including immunotherapy

Shinji Nakamichi


Small-cell lung cancer (SCLC) shows the rapid clinical course in lung cancer. Median survival times have prolonged with improved management of patients.

 In patients with extended disease (ED)-SCLC patients, cisplatin and etoposide had been as a standard treatment. Based on JCOG 9511 and following meta-analyses, cisplatin and irinotecan has also become standard in patients under 70 especially in Japan. Impower133 study results showed significantly longer overall survival in patients received carboplatin, etoposide and atezolizumab than carboplatin and etoposide. Standard treatment for limited disease (LD)-SCLC patients is regarded as cisplatin and etoposide with concurrent chemoradiotherapy. JCOG 0202 was conducted to compare cisplatin + irinotecan and cisplatin + etoposide as the consolidation therapy after chemoradiotherapy. The overall survival from randomization did not differ between the two groups. Cisplatin + etoposide still remain standard treatment method for LD-SCLC.

A lot of treatment methods including immunotherapy for SCLC are under clinical trial as promising treatment option. The choice of treatment should be determined based on a good communication with patients.


small-cell lung cancer; ED-SCLC; LD-SCLC; immune checkpoint inhibitor; IMpower133

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