Leveraging Biomarkers and Heterogeneity to Elevate SCLC Care

Anne Chiang, MD, PhD, spoke with CancerNetwork® about the next big steps that the small cell lung cancer (SCLC) field needs to take to improve the prognosis for patients. She outlined a few key themes for the future of the field, which included the sequencing of therapies, the use of biomarkers, and the leveraging of disease heterogeneity.

According to Chiang, an associate professor of medicine in the Section of Medical Oncology at Yale School of Medicine, determining the patients who are at a higher risk is crucial for informing how to sequence different lines of treatment. Additionally, understanding disease and treatment heterogeneity among patients may help with the management of adverse effects (AEs).

One area of unmet need, Chiang said, related to the treatment of patients with brain metastases. Additionally, she noted that she wanted to keep the notion of a cure “on the table,” describing how chimeric antigen receptor (CAR) T-cell therapies or similar immunotherapy-based approaches may be important to consider.

Transcript:

Understanding and leveraging the biology is important. We’re going to need to understand how to sequence therapies, and that involves understanding which patients are at higher risk. [That is] No. 1. No. 2, which biomarkers can we use? We’re still struggling to understand how to use our biomarkers. No. 3, we need to understand the heterogeneity of which treatments will work for each group of patients and, ultimately, how to manage [AEs] as well. Those are different options.

We need to look at high-risk populations—for example, patients with brain metastases—and understand which therapies are especially useful for them. That’s an area of unmet need. We need to learn how to cure these patients too. I want to keep that on the table. Maybe utilizing CAR T therapies or things that can teach the immune system, long term, how to recognize cancer cells is important to keep in mind.