Unmet Needs in Maintenance Therapy for Extensive Stage Small Cell Lung Cancer

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer Pub Date : 2025-03-01 DOI:10.1016/j.cllc.2025.02.015

Luis Paz-Ares , Brinda Gupta , Javier Baena , Stephen V. Liu

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引用次数: 0

Abstract

Small cell lung cancer (SCLC) is a highly aggressive malignancy and an exceptionally lethal disease; most patients present with extensive stage (ES) disease at diagnosis. Very little had changed in the treatment of ES-SCLC for decades until immune checkpoint inhibitor (ICI) therapy combined with chemotherapy followed by ICI maintenance monotherapy was added to standard treatment paradigms in 2019. Despite this important advance, high rates of relapse are still observed in patients with ES-SCLC and long-term survival rates remain low, with approximately 40% of patients proceeding to receive second-line treatment. There is an urgent need for novel treatment strategies to improve patient outcomes. In this review, we describe the rationale for maintenance therapy approaches in ES-SCLC and summarize the existing data on chemotherapy, ICIs, and other agents in the first-line maintenance setting. Predictive biomarkers, SCLC subtypes, and new therapeutics in development are discussed including lurbinectedin, antibody-drug conjugates, and T-cell engager molecules.

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广泛期小细胞肺癌维持治疗未满足的需求。

小细胞肺癌（SCLC）是一种高度侵袭性的恶性肿瘤，是一种非常致命的疾病；大多数患者在诊断时呈现广泛期（ES）疾病。几十年来，ES-SCLC的治疗几乎没有什么变化，直到2019年将免疫检查点抑制剂（ICI）治疗联合化疗后的ICI维持单药治疗添加到标准治疗范式中。尽管有这一重要进展，ES-SCLC患者的复发率仍然很高，长期生存率仍然很低，大约40%的患者继续接受二线治疗。迫切需要新的治疗策略来改善患者的预后。在这篇综述中，我们描述了ES-SCLC维持治疗方法的基本原理，并总结了化疗、ICIs和其他药物在一线维持治疗中的现有数据。预测性生物标志物，SCLC亚型，和新的治疗方法在开发中进行了讨论，包括lurbinectedin，抗体-药物偶联物，和t细胞接合分子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical lung cancer 医学-肿瘤学

CiteScore

7.00

自引率

2.80%

发文量

159

审稿时长

24 days

期刊介绍： Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.