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, Anne Chiang, MD, PhD, spoke about the current treatment landscape for those with small cell lung cancer (SCLC) as well as next steps for elevating the quality of care among patients. She began by outlining the evolution of therapeutic standards in the field, with atezolizumab (Tecentriq)- and durvalumab (Imfinzi)-based regimens emerging as key frontline strategies and lurbinectedin (Zepzelca) and tarlatamab-dlle (Imdelltra) demonstrating utility as second-line therapies.

Regarding novel treatments that may hold promise in the SCLC field, Chiang, an associate professor of medicine in the Section of Medical Oncology at Yale School of Medicine in New Haven, Connecticut, highlighted her work on the phase 2 SWOG S2409 PRISM trial (NCT06769126). Here, Chiang and colleagues plan to collect tissue from more than 800 patients undergoing frontline induction therapy with chemoimmunotherapy to inform subsequent biomarker-directed treatment, which may help elucidate factors of disease heterogeneity in the process.

The conversation also focused on considerations for improving the care of those with lung cancer in community-based settings, as Chiang emphasized spreading knowledge of therapeutic advances to a broader patient population. She noted that there is “still a bit of nihilism about the prognosis” of patients with SCLC, describing a need to further leverage the field’s understanding of biology to impart the benefits of immunotherapy to more patients. Chiang also detailed the importance of employing patient-reported outcomes to hear directly from the patient, which may ensure their inclusion in the shared decision-making process and optimize strategies for mitigating potential adverse effects during treatment.

“Understanding and leveraging the biology is important. We are going to need to understand how to sequence therapies, and that involves understanding which patients are at higher risk,” Chiang stated regarding future initiatives in the field. “We need to look at high-risk populations—for example, patients with brain metastases—and understand which therapies are especially useful for them.”

“Paradigm-changing events” are occurring across the small cell lung cancer field in real time, according to Anne Chiang, MD, PhD.

Leveraging Biology to Advance the Small Cell Lung Cancer Treatment Paradigm

2025 American Society of Clinical Oncology (ASCO) Annual Meeting

, CancerNetwork® put together an X Spaces discussion hosted by Stephen Liu, MD; and Joshua Sabari, MD, to highlight the most intriguing and practice-changing lung cancer abstracts. Discussed topics ranged from long-term follow-up with commonplace therapies to an analysis of what time of day is best to administer immunochemotherapy.

Liu, an associate professor of medicine at Georgetown University and the director of thoracic oncology and head of developmental therapeutics at the Georgetown Lombardi Comprehensive Cancer Center, and Sabari, an assistant professor in the Department of Medicine at the New York University Grossman School of Medicine and the director of high reliability organization initiatives at the Perlmutter Cancer Center, shared expert insights on the latest non–small cell lung cancer (NSCLC) and SCLC breakthroughs.

Trials of note that they discussed included:

The phase 3 DeLLphi-304 trial (NCT05740566)

: "Tarlatamab (Imdelltra) vs Chemotherapy (CTx) as Second-Line (2L) Treatment for Small Cell Lung Cancer (SCLC): Primary Analysis of Ph3 DeLLphi-304"

: "Lurbinectedin (Lurbi) + Atezolizumab (Atezo) as First-Line (1L) Maintenance Treatment (tx) in Patients (pts) With Extensive-Stage Small Cell Lung Cancer (ES-SCLC): Primary Results of the Phase 3 IMforte Trial"

The phase 3 CheckMate 816 trial (NCT02998528)

: "Overall Survival With Neoadjuvant Nivolumab (NIVO) + Chemotherapy (Chemo) in Patients With Resectable NSCLC in CheckMate 816"

The phase 3 PACIFIC15 trial (NCT05549037): "Randomized Trial of Relevance of Time-of-Day of Immunochemotherapy for Progression-Free and Overall Survival in Patients With Non–Small Cell Lung Cancer"

The phase 3 Beamion LUNG-1 trial (NCT04886804): "Patient-Reported Outcomes (PRO) Evaluating Physical Functioning and Symptoms in Patients With Pretreated HER2-Mutant Advanced Non-Small Cell Lung Cancer (NSCLC): Results From the Beamion LUNG-1 trial"

The phase 3 ARTEMIA trial (NCT06472245): "Phase 3 Trial of the Therapeutic Cancer Vaccine OSE2101 Versus Docetaxel in Patients With Metastatic Non-Small Cell Lung Cancer and Secondary Resistance to Immunotherapy"

Rudin C, Mountzios G, Sun L, et al. Tarlatamab versus chemotherapy (CTx) as second-line (2L) treatment for small cell lung cancer (SCLC): primary analysis of ph3 DeLLphi-304. 

. 2025;43(suppl 17):LBA8008. doi:10.1200/JCO.2025.43.17_suppl.LBA8008

Paz-Ares L, Borghaei H, Liu SV, et al. Lurbinectedin (lurbi) + atezolizumab (atezo) as first-line (1L) maintenance treatment (tx) in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC): primary results of the phase 3 IMforte trial. 

2025;43(suppl 16):8006. doi:10.1200/JCO.2025.43.16_suppl.8006

Forde PM, Spicer JD, Provencio M, et al. Overall survival with neoadjuvant nivolumab + chemotherapy in patients with resectable NSCLC in CheckMate 816. 

. 2025;43(suppl 17):LBA8000. doi:10.1200/JCO.2025.43.17_suppl.LBA8000

Zhang Y, Huang Z, Zeng L, et al. Randomized trial of relevance of time-of-day of immunochemotherapy for progression-free and overall survival in patients with non-small cell lung cancer. 

. 2025;43(suppl 16):8516. doi:10.1200/JCO.2025.43.16_suppl.8516

Sabari JK, Nadal E, Hendriks L, et al. Patient-reported outcomes (PRO) evaluating physical functioning and symptoms in patients with pretreated HER2-mutant advanced non-small cell lung cancer (NSCLC): results from the Beamion LUNG-1 trial. 

2025;43(suppl 16):8620. doi:10.1200/JCO.2025.43.16_suppl.8620

Liu SV, Guibert C, Tostivint EP, et al. Phase 3 trial of the therapeutic cancer vaccine OSE2101 versus docetaxel in patients with metastatic non-small cell lung cancer and secondary resistance to immunotherapy. 

. 2025;43(suppl 16):TPS8651. doi:10.1200/JCO.2025.43.16_suppl.TPS8651

ASCO Annual Meeting: Lung Cancer

Stephen Liu, MD; and Joshua Sabari, MD, discuss the most intriguing non–small cell lung cancer and small cell lung cancer breakthroughs from the meeting. 

Practice-Changing Lung Cancer Data From the 2025 ASCO Annual Meeting

In the second edition of a special podcast series, CancerNetwork

 spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about the best practices for incorporating recently approved bispecific antibodies into cancer care. This discussion focused on clinical trial results, administration protocols, and adverse effect (AE) management strategies related to the use of tarlatamab-dlle (Imdelltra) for patients with small cell lung cancer (SCLC).

Morgensztern is a professor of Medicine and the clinical director of Thoracic Oncology in the Division of Oncology at Washington University School of Medicine in St. Louis. Flanagan is a nurse practitioner in the Division of Thoracic Oncology at Washington University. Mann is a clinical oncology pharmacist at Siteman Cancer Center of Washington University School of Medicine and manager of Clinical Pharmacy Services at Barnes-Jewish Hospital.

The conversation opened with Morgensztern highlighting tarlatamab’s mechanism of action as an agent that targets DLL3. He then reviewed prior efficacy data that the therapy demonstrated in the phase 1 DeLLphi-300 trial (NCT03319940) and the phase 2 DeLLphi-301 trial (NCT05060016). Of note, the 

 as the first available T-cell engager immunotherapy for patients with extensive-stage SCLC who have progressed on prior platinum-containing chemotherapy in May 2024 based on data from the DeLLphi-301 trial.

Additionally, Flanagan detailed strategies for monitoring and mitigating the most common AEs associated with tarlatamab in this patient population, which include cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome. Mann then outlined considerations for properly dosing and administering the agent, highlighting factors that clinicians should keep in mind when continuing treatment in an inpatient or outpatient setting.

The group also spoke about clinical decision-making related to patients who have brain metastases, which included processes for adjusting the dose of tarlatamab and sequencing the bispecific agent with radiotherapy.

FDA grants accelerated approval to tarlatamab-dlle for extensive stage small cell lung cancer. News release. FDA. May 16, 2024. Accessed March 14, 2025. https://tinyurl.com/48k34rw5

Experts from Washington University in St. Louis discuss prior data and strategies for mitigating toxicities like CRS associated with tarlatamab in SCLC.

Considering Dosing and AE Management Strategies With Tarlatamab in SCLC

In a conversation with CancerNetwork®, Gregory Peter Kalemkerian, MD, spoke about the publication of updated guidelines for managing small cell lung cancer (SCLC) with systemic therapy, which was developed by the American Society of Clinical Oncology (ASCO) in collaboration with Ontario Health (Cancer Care Ontario).

Kalemkerian, a clinical professor at The University of Michigan and senior author of the guidelines, discussed developments in the SCLC field that inspired the creation of the revised guidelines since the last publication from ASCO in 2015.

 Although the latest guidelines contained recommendations concerning treatment modalities such as surgery and radiotherapy, Kalemkerian said that the biggest advances related to the integration of immunotherapy into frontline treatment for patients with extensive-stage SCLC (ES-SCLC).

Specifically, Kalemkerian highlighted the use of immunotherapeutic agents such as durvalumab (Imfinzi) and atezolizumab (Tecentriq), which have demonstrated long-term improvements in survival of those with ES-SCLC. The guideline authors issued a strong recommendation backed by high-quality evidence for the frontline use of carboplatin plus etoposide or cisplatin plus atezolizumab or durvalumab followed by maintenance immunotherapy in patients with ES-SCLC who have no contraindications to immunotherapy.

 Additionally, there was no evidence supporting the continuation of immunotherapy for those with relapsed SCLC and progressive disease following maintenance immunotherapy based on an informal consensus.

With respect to other updates in the guidelines, Kalemkerian spoke about optimal treatment strategies for patients with poorer performance statuses as well as the potential role of biomarkers in SCLC. Although there are currently no validated biomarkers that have demonstrated utility in the management of SCLC, he stated that it was necessary to overhaul how practices understand how diseases like SCLC develop and grow to help improve patient outcomes.

“I would like people to pay attention to SCLC a little bit,” Kalemkerian said. “Non–small cell lung cancer has gotten a lot of the press and hype over the last 20 years or so since targeted therapy came out for that disease. Before that, we all thought SCLC was where we were going to be making advances, and we were wrong. We’re on the cusp of understanding the disease better and utilizing that understanding to advance newer strategies for trying to treat these patients.”

Khurshid H, Ismaila N, Bian J, et al. Systemic therapy for small-cell lung cancer: ASCO-Ontario Health (Cancer Care Ontario) guideline. 

. 2023;41(35):5448-5472. doi:10.1200/JCO.23.01435

Rudin CM, Ismaila N, Hann CL, et al. Treatment of small-cell lung cancer: American Society of Clinical Oncology endorsement of the American College of Chest Physicians Guideline. 

. 2015;33(34):4106-4111. doi:10.1200/JCO.2015.63.7918.

Practices are on the cusp of better understanding small cell lung cancer that in turn can help to advance treatment strategies for patients, says Gregory Peter Kalemkerian, MD.

Updated ASCO Guidelines for Optimal Small Cell Lung Cancer Management

The final episode of CancerNetwork’s 4-part series on small cell lung cancer (SCLC) welcomes back Wade Iams, MD, a thoracic medical oncologist at the Vanderbilt University Medical Center. In this conversation, Iams looks to the future of SCLC treatments, touching on topics including extending response durations for patients, emerging therapies for extensive stage SCLC, exciting research on the horizon, and more.

Don’t forget to subscribe to the "Oncology Peer Review On-The-Go" podcast on Apple Podcasts, Spotify, or anywhere podcasts are available.

Check out the previous podcast episodes in this series:

Episode 1: First-Line Therapeutic Options in Small Cell Lung Cancer

Episode 2: Treatment Options for Relapsed/Refractory Small Cell Lung Cancer

Episode 3: Practical Considerations for Small Cell Lung Cancer Therapeutic Options

In the final part of the small cell lung cancer podcast series, CancerNetwork® and Wade Iams, MD, discuss the future of treating patients with this disease.

Oncology Peer Review On-The-Go: Future Directions in Small Cell Lung Cancer Treatment

In the third part of a 4-part series on small cell lung cancer (SCLC), CancerNetwork spoke with Wade Iams, MD, a thoracic medical oncologist at the Vanderbilt University Medical Center about the occurrence of toxicities associated with treatment, quality of life for patients, and managing and mitigating those events for individuals with SCLC. Some of the agents and regimens discussed include lurbinectedin (Zepzelca) and trilaciclib (Cosela), as well as chemotherapy and immunotherapy.

In episode 3 of a 4-part small cell lung cancer podcast series, Wade Iams, MD, highlights practical considerations for treating patients with small cell lung cancer, including managing toxicities and the impact of treatment on a patient’s quality of life.

Oncology Peer Review On-The-Go: Practical Considerations for Small Cell Lung Cancer Therapeutic Options

In the second part of our 4-part series on small cell lung cancer (SCLC), CancerNetwork® continued its conversation with Wade Iams, MD, a thoracic medical oncologist at Vanderbilt University Medical Center. Iams turned attention towards different treatment options that are currently available for patients with relapsed/refractory SCLC. Among others, Iams touched on lurbinectedin (Zepzelca), topotecan, and some of the crucial clinical trials associated with treatment options for SCLC. These studies included a phase 2 basket trial (NCT02454972) that assessed the use lurbinectedin as a second-line therapy in relapsed SCLC and phase 3 ATLANTIS trial (NCT02566993), which examined second-line lurbinectedin in combination with doxorubicin in patients with SCLC.

Check out the first episode of this series on 

first-line therapeutic options in small cell lung cancer

Wade Iams, MD, broke down some of the different treatment options, including lurbinectedin and topotecan, for patients with relapsed/refractory small cell lung cancer in the second episode of a 4-part small cell lung cancer podcast series.

Oncology Peer Review On-The-Go: Treatment Options for Relapsed/Refractory Small Cell Lung Cancer

In this special episode of the "Oncology Peer Review On-The-Go" podcast, CancerNetwork® spoke with Wade Iams, MD, a thoracic medical oncologist at the Vanderbilt University Medical Center, about therapeutic advances for small cell lung cancer (SCLC). Iams spotlighted the current first-line therapies that are available for patients with SCLC and the factors considered for treating patients in the first-line setting. He also discussed the phase 3 IMpower133 trial (NCT02763579) evaluating the safety and efficacy of atezolizumab (Tecentriq) in combination with carboplatin and etoposide for patients with extensive stage SCLC and the phase 3 CASPIAN trial (NCT03043872) examining the efficacy and safety of durvalumab (Imfinzi) with or without tremelimumab combined with platinum-based chemotherapy for patients with extensive stage SCLC.

In the first episode of a 4-part series, CancerNetwork® spoke with Wade Iams, MD, about the various first-line treat options that are available for patients with small cell lung cancer.

Oncology Peer Review On-The-Go: First-Line Therapeutic Options in Small Cell Lung Cancer

As part of its OncView™ video series, CancerNetwork® spoke with Benjamin Levy, MD, of the John Hopkins Sidney Kimmel Comprehensive Cancer Center, to discuss frontline management of extensive-stage small cell lung cancer (SCLC) and the recent updates in the field.

In the video series, Levy discussed the following:

Small Cell Lung Cancer: Risk and Prognosis

Extensive-Stage Small Cell Lung Cancer: Gaps in Treatment

Immunotherapy for First-Line Extensive-Stage SCLC

First-Line I-O Plus Chemotherapy for Extensive-Stage SCLC

Significance of the IMpower133 Trial in Extensive-Stage SCLC

To watch more videos in CancerNetwork®’s OncView™ series, visit 

Don’t forget to subscribe to the "Oncology Peer Review On-The-Go" podcast wherever you get your podcasts.

This special edition of the “Oncology Peer Review On-The-Go” dives into recent updates and important treatment strategies for extensive-stage SCLC management.

OncView™ Podcast: Updates in Managing Extensive-Stage Small Cell Lung Cancer

As part of the OncView™ video series, CancerNetwork® spoke with Mark Socinski, MD, of the AdventHealth Cancer Institute in Orlando, Florida, about updates in the management of extensive-stage small cell lung cancer (ES-SCLC).

In the video series, Socinski discussed the following:

Treatment Challenges in Extensive-Stage SCLC

Immunotherapy as First-Line Treatment for Extensive-Stage SCLC

The IMpower133 Trial in Extensive-Stage SCLC

Extensive-Stage SCLC: Implications of IMpower133

This special edition of the “Oncology Peer Review On-The-Go” podcast hosts Mark Socinski, MD, who discusses important factors in treating and managing extensive-stage small cell lung cancer, and details information from the IMpower133 trial.

OncView™ Podcast: Front-Line Management of Extensive-Stage SCLC

Grade 3 immune-mediated AEs were observed in 11 patients with extensive-stage small cell lung cancer, which included 2 instances of pneumonitis.

Durvalumab Plus Platinum-Etoposide Displays Feasibility in ES-SCLC

In a spotlight session at the Chemotherapy Foundation Symposium, Anne Chiang, MD, PhD, covered developments in the field of LS-SCLC.

Delving Into the Current State of Clinical Practice in SCLC

Data from the DeLLphi-304 trial support the full approval of tarlatamab in this extensive-stage small cell lung cancer population.

Tarlatamab Earns Traditional FDA Approval in ES-SCLC

Patients with ES-SCLC who had an ECOG performance status of 2 or 3 achieved ORRs of 52.4% and 45.5%, respectively, with the study treatment.

Durvalumab/Carboplatin/Etoposide Proves Tolerable in ES-SCLC

Data show that XCR1-positive conventional type 1 dendritic cells may play a role as mediators of response to atezolizumab in extensive-stage SCLC.

Small Cell Lung Cancer (SCLC)

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