Small Cell Lung Cancer: Biology Advances

Small-cell lung cancer (SCLC) represents about 13% of all lung cancers and is hallmarked by early metastatic behavior and poor prognosis. Recently immune checkpoint inhibitors have been approved for use in combination with etoposide plus a platinum agent as initial therapy for patients extensive stage SCLC; with the triplet regimen, the median overall survival is approximately 12 months. Over the past 4 years, several agents, including immune checkpoint inhibitors, have also received FDA-approval for SCLC in the relapsed setting, based primarily on objective response rates or duration of response, but not improvement in survival. Analyses of SCLC models have identified molecular subtypes based on the relative expression of key transcriptional regulators. These analyses are leading to a better understanding of SCLC biology and may help identify distinct therapeutic vulnerabilities among subsets of this disease. Ideally, these investigations will lead to more personalized therapeutic approaches and better outcomes for patients diagnosed with this aggressive cancer.