Current state of the art and future perspectives with immunotherapy in the management of small cell lung cancer

Introduction: Small cell lung cancer (SCLC) is an aggressive tumor with a severe prognosis. At the time of diagnosis, most patients present with extensive-stage (ES) disease. For decades, platinum-based chemotherapy has been the only pillar of SCLC treatment, but now, the clinical management of this disease is rapidly evolving thanks to the introduction of immune checkpoint inhibitors (ICIs). Areas covered: In this review, we describe the most recent advances in the treatment of SCLC and discuss the emerging challenges associated with ICI treatments. Meaningful data were collected from the currently available literature on PubMed and in international oncology meetings. Expert opinion: Recently, meaningful improvements in outcomes of SCLC patients have been achieved with anti-PD-L1 atezolizumab or durvalumab combined with chemotherapy in first line. Results of studies evaluating the role of ICIs in limited-stage (LS) SCLC patients are awaited. Further efforts are required to better understand the role of immunotherapy in the treatment of SCLC and to identify patients most likely to benefit from this treatment strategy.