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Immunotherapy Infiltrates Small Cell Lung Cancer Treatment, But Biomarkers Remain Elusive

Jessica Hergert
Published: Sunday, Mar 15, 2020

Jason Niu, MD, PhD, a thoracic oncologist and director of the Lung Cancer Program at the Banner MD Anderson Cancer Center

Jason Niu, MD, PhD

After nearly 4 decades of stagnation, the advent of immunotherapy has transformed the frontline treatment paradigm for patients with extensive-stage small cell lung cancer (ES-SCLC). However, biomarkers are needed to better inform which patients are most likely to respond to checkpoint inhibitors, said Jason Niu, MD, PhD.

"We have tried many different [strategies] to improve platinum/etoposide therapy, which was standard for at least 30 years, including adding paclitaxel or ifosfamide," said Niu. "The bottom line was that we had over 40 failed trials. It was quite a deflating experience and it was frustrating for medical oncologists who treat [patients with] this disease."

In March 2019, the combination of atezolizumab (Tecentriq) and chemotherapy was approved by the FDA for the frontline treatment of adults with ES-SCLC, based on findings from the phase III IMpower133 trial. Results showed that there was a 30% reduction in the risk of death with the combination versus chemotherapy alone (HR, 0.70; 95% CI, 0.54-0.91; P = .0069).1 Updated findings demonstrated a continued overall survival (OS) benefit with the combination (HR, 0.76; 95% CI, 0.60-0.95; P = .0154).2

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