Therapy Selection in Small Cell Lung Cancer With Disease Progression After Platinum-Based Therapy .
Key Takeaways
- The use of immune checkpoint inhibitors (ICIs) in small cell lung cancer (SCLC) has had mixed success so far, despite many SCLCs having a high neoantigen load. Investigations are underway to evaluate why responses are often underwhelming and to trial approaches to attenuate the immune response.
- Lurbinectedin is generally preferred to topotecan in patients with SCLC who have progressed after platinum-based therapy and are not eligible for or interested in participating in clinical trials.
- Establishment of effective preclinical models for research on SCLC is inhibited by the lack of tissue available, as patients do not frequently undergo surgical resection.
- No validated predictive biomarkers for platinum resistance exist for clinical use in SCLC, and this represents a significant unmet need in the treatment of the disease.
- Liquid biopsies looking at circulating tumor DNA (ctDNA) are underutilized in SCLC currently, but the increased volume of genomic data now available means they are likely to have more application in the coming years .
Misty Shields, MD, PhD, is a thoracic oncologist and assistant professor of clinical medicine in the Department of Medicine and Division of Hematology/Oncology at Indiana University School of Medicine in Indianapolis. Her clinical research interests in relation to patients with SCLC include clinical trials featuring novel therapies and approaches. In this article, Dr Shields discusses the efficacy and safety of lurbinectedin compared with other therapies, the use of liquid biopsies, and the impact of early palliative care approaches on quality of life and survival . ...