REVISIT ES-SCLC
SETTING THE COURSE FOR
A NEW TREATMENT OPTION
ES-SCLC=extensive-stage small cell lung cancer.
ES-SCLC: THE URGENCY IS REAL
THE MOST AGGRESSIVE SUBTYPE OF LUNG CANCER CONTINUES TO CHALLENGE PHYSICIANS AND PATIENTS1
Small cell lung cancer (SCLC) accounts for 10%-15% of all lung cancers; and 2/3 of SCLC cases are extensive-stage (ES-SCLC)2,3
ES-SCLC shows rapid proliferation, high growth fraction, and early development of widespread metastases. Most patients relapse within 6 months after first-line treatment1,4
LIMITED IMPROVEMENT IN SURVIVAL RATES
ES-SCLC median overall survival (mOS) is 10 months with platinum-etoposide chemotherapy alone5,7
Even with newer, more advanced
ES-SCLC treatment options, mOS is only ~12 to 13 months4,6,7
5-year survival for all SCLC patients remains 9%3
A SLOW ROAD TO CHANGE AND INNOVATION
- Over the past 20 years, the only major advancement in first-line therapy for ES-SCLC has been the addition of anti-PD-L1 inhibitors to platinum-based chemotherapy—atezolizumab in 2019 and durvalumab in 20204,8-10
- Clinical efficacy studies of the PD-1 inhibitor pembrolizumab and nivolumab in first-line ES-SCLC failed to demonstrate a benefit to overall survival11
ES-SCLC=extensive-stage small cell lung cancer; mOS=median overall survival; PD-1=programmed cell death 1; PD-L1=programmed cell death ligand 1.
References: 1. Dingemans AC, Früh M, Ardizzoni A, et al. Small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021;32(7):839-853. doi:10.1016/j.annonc.2021.03.207 2. American Cancer Society. Cancer Facts & Figures 2025. Accessed November 10, 2025. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2025-cancer-facts-figures.html 3. American Cancer Society. Small cell lung cancer stages. Accessed November 10, 2025. https://www.cancer.org/cancer/types/lung-cancer/detection-diagnosis-staging/staging-sclc.html 4. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology {NCCN Guidelines®) for Small Cell Lung Cancer V.4.2025. ©National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed July 29, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 5. Cheng Y, Han L, Wu L, et al. Effect of first-line serplulimab vs placebo added to chemotherapy on survival in patients with extensive-stage small cell lung cancer: the ASTRUM-005 randomized clinical trial. JAMA. 2022;328(12):1223-1232. 6. Goldman JW, Dvorkin M, Chen Y, et al. Durvalumab, with or without tremelimumab, plus platinum-etoposide versus platinum-etoposide alone in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): updated results from a randomised, controlled, open-label, phase 3 trial. Lancet Oncol. 2021;22(1):51-65. doi:10.1016/S1470-2045(20)30539-8 7. Horn L, Mansfield AS, Szczęsna A, et al. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med. 2018;379(23):2220-2229. doi:10.1056/NEJMoa1809064 8. Uprety D, Seaton R, Niroula A, Hadid T, Parikh K, Ruterbusch JJ. Trends in the incidence and survival outcomes in patients with small cell lung cancer in the United States: an analysis of the SEER database. Cancer Med. 2025;14(3):e70608. doi:10.1002/cam4.70608 9. FDA. FDA approves atezolizumab for extensive-stage small cell lung cancer. Accessed July 29, 2025. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-atezolizumab-extensive-stage-small-cell-lung-cancer 10. FDA. FDA approves durvalumab for extensive-stage small cell lung cancer. Accessed July 29, 2025. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-durvalumab-extensive-stage-small-cell-lung-cancer 11. Rudin CM, Awad MM, Navarro A, et al. Pembrolizumab or placebo plus etoposide and platinum as first-line therapy for extensive-stage small-cell lung cancer: randomized, double-blind, phase III KEYNOTE-604 Study. J Clin Oncol. 2020;38(21):2369-2379. doi:10.1200/JCO.20.00793