First-Line Extensive-Stage SCLC: Examining the New Role of Combination Chemotherapy and Immunotherapy - Episode 10

Ongoing Research in Extensive-Stage Small Cell Lung Cancer

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Kathryn Gold, MD: What ongoing research are you excited about in this setting?

Konstantinos Leventakos, MD, PhD: First is the role of immunotherapy. Because we see it working, we feel that we have maximized its effects. The clinical trials are looking into more agents that compare with better outcomes. At the same time, we have been finding other targets like the DLL3. There is not really a successful clinical trial on that, but maybe this is a target that we can take up front in a different way. At the same time, we have more clinical trials coming that focus on the genetic defects of small cell lung cancer, like the PARP inhibitors. We’ll be looking, so we’ll need more preclinical data to identify more biomarkers and be able to have more targeted therapies because targeted therapies are what help us with the adenocarcinomas.

Kathryn Gold, MD: Taofeek, what are you excited about that’s coming down the pipeline?

Taofeek K. Owonikoko, MD, PhD: The field, as a whole, is going to benefit from these large, randomized trials where samples are collected. The more we look, the more likely we are to find something, even if we don’t know what we’re looking for. Having said that, the ongoing trials of immunotherapy approaches in limited-stage disease is very exciting. I look forward to seeing those results, and I’m hopeful that they will look like what we’ve seen with locally advanced non–small cell lung cancer. The other approaches are, as Konstans indicated, the addition of targeted therapy to immunotherapy and to radiation in the maintenance setting for extensive-stage disease, as well as the anti-DLL3 strategy for the relapse setting. The initial foray with the antibody-drug conjugate was not very successful, but we now have 2 bispecific T-cell–engaging antibodies in clinical testing. Those look really promising; we’ll see where they lead us. Finally, understanding the certainty of small-cell subtypes is one thing that will really help drive the field forward. We have the f4 main subtypes: ASCL1, NEUROD1, POU2F3, and YAP1 subtypes of small cell. We are beginning to see that these different subtypes have different phenotypes, and that could help us try to match the subtype with specific treatment approaches. I’m really excited by that opportunity going forward.

Kathryn Gold, MD: Awesome. Thank you both for being here. This has been an excellent discussion. We hope you found the information to be valuable to your clinical practice, and thank you for watching OncLive® News Network®.

Transcript Edited for Clarity