Despite Challenges, Treatments Advance for Small Cell Lung Cancer

Small cell lung cancer, constituting about 15% of all lung cancer diagnoses, has historically presented formidable challenges in treatment. However, recent progress in research offers hope for patients who have received this diagnosis, as Amy C. Moore, vice president of global engagement and patient partnerships for LUNGevity, told CURE® as part of the “Speaking Out” video series.

Moore discussed several clinical trials showcasing significant advancements. Notably, the IMpower133 trial showed a five-year overall survival (how long patients lived following treatment, regardless of disease status) of 12% among patients treated with the immunotherapy Tecentriq (atezolizumab) plus chemotherapy, a substantial improvement compared to the mere 2% survival rate in patients receiving only chemotherapy.

While identifying which patients benefit most from this combined approach remains a challenge, ongoing research aims to pinpoint biomarkers that predict treatment response, Moore said.

Similarly, the CASPIAN study demonstrated promising outcomes by pairing the immunotherapy drug Imfinzi (durvalumab) with platinum-based chemotherapy. This combination exhibited three times more survivors at three years compared to those treated with standalone chemotherapy. These studies underscore the efficacy of combining immunotherapy with traditional chemotherapy, offering survival benefits for patients with extensive-stage SCLC.

Immunotherapy operates by leveraging the body's immune system to target cancer cells, representing a significant paradigm shift in cancer treatment.

Despite these advancements, several hurdles remain, including the relative rarity of SCLC compared to non-small cell lung cancer (NSCLC).

“Despite all the advances we've made in the treatment of non-small cell lung cancer, where we have a number of actionable biomarkers and targeted therapies and immunotherapy that have really opened up the survival and quality of life for those patients, we haven't seen the same gains in patients diagnosed with small cell [lung cancer],” said Moore. “We're trying to understand biologically what's different about small cell. Patients diagnosed tend to be diagnosed at late stages. It's a more aggressive form of the disease, a more aggressive form of lung cancer, so it often responds well initially to chemotherapy but then the tumor, it does what it does, and patients can find that the chemotherapy stops working. And so, we just don't have as many options available for small cell as we do for non-small cell, but it's an area of intense investigation.”

Ongoing research explores novel treatment modalities. The DeLLphi-301 study investigated tarlatamab, a bispecific T-cell engager that bridges SCLC cells with T-cells, facilitating targeted cell destruction. Additionally, antibody drug conjugates (ADCs) show promise by selectively delivering drugs to cancer cells, potentially enhancing treatment efficacy.

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