Case 3: Second-Line Treatment for SCLC

Second-line therapy remains a major clinical challenge, with limited durable options after progression on chemo-immunotherapy. Panelists discuss the criteria for rechallenging with platinum-based regimens vs switching to drugs with new mechanisms of action. The decision depends on factors such as time since prior therapy, residual toxicity, and overall performance status.

Treatment duration is guided by response and tolerability rather than fixed cycles. In practice, patient frailty often limits intensive regimens, leading clinicians to individualize therapy duration to preserve functional status.

Ultimately, the panel emphasizes that evidence-based decision-making, patient goals, and real-world feasibility must guide second-line treatment, underscoring the urgent need for novel agents in this space.