Top advances of the year: Small cell lung cancer

Abstract

Lung cancer remains the leading cause of cancer-related mortality in both men and women. Small cell lung cancer (SCLC) is notorious for its early metastatic spread, aggressive biology, and high frequency of disease relapse, resulting in inferior outcomes. In the last few years, immunotherapy for extensive-stage SCLC has offered a glimmer of hope by improving survival by approximately 2 months. In 2024, therapeutic breakthroughs for SCLC led to a meaningful impact for patients, offering potential for long-term survival. Here, the authors report the top advances from 2024, including the practice-changing implementation of consolidative durvalumab immunotherapy for limited-stage SCLC, lessons learned from the timing of immunotherapy with radiation using LU-005, how the delta-like ligand 3 bispecific T-cell engager tarlatamab affects the relapsed landscape, the addition of lurbinectedin to atezolizumab immunotherapy for extensive-stage SCLC, and the promising role of antibody–drug conjugates. In a forward-thinking approach, the authors discuss the feasibility of biomarker selection with the Southwest Oncology Group SWOG S1929 study and how precision medicine may inform consolidative treatments for extensive-stage SCLC through neuroendocrine subtyping with the Southwest Oncology Group SWOG S2409 (PRISM) trial. Finally, they conclude with the exciting role of advocacy with the newly formed advocacy group Small Cell SMASHERS, amplifying support for SCLC. In 2024, the scientific revolution for SCLC has arrived, spearheading a new era of change for this disease.