Researchers continue to examine new drugs and new combinations of drugs to treat small-cell lung cancer (SCLC). Learn about newly approved drugs, combination treatments, and future therapies currently under investigation.
Small-cell lung cancer (SCLC) makes up about
The late stage disease is primarily treated with:
- chemotherapy
- radiation therapy
- immunotherapy
Researchers are continuing to investigate new treatment options for SCLC by:
- studying new drugs
- examining whether drugs used for other cancers are also effective for SCLC
- studying new combinations of already approved drugs
In this article, we look at some of the most recently approved treatment options and some of the potential future treatment options that are currently under investigation in clinical trials. Visit the National Cancer Institute website for a full list of
What are clinical trials?
Clinical trials are studies that investigate new treatment options to see if they’re safe and effective. A treatment can become the new standard treatment if data from clinical trials show that it’s more effective than the current standard treatment and has an acceptable safety level.
Clinical trials are classified into phases depending on how far the research has advanced. Here’s the approximate goal of each phase:
- Phase 1: examine whether a treatment is safe
- Phase 2: examine whether a treatment is effective
- Phase 3: examine the strength of a treatment’s benefit compared with current treatments
- Phase 4: examine long-term side effects
The Food and Drug Administration (FDA) granted accelerated approval to lurbinectedin (Zepzelca) on
“Metastatic SCLC” means the cancer has spread to distant body parts. Platinum-based chemotherapy combined with the drug etoposide is the
Lurbinectedin falls into a class of chemotherapy medications called “alkylating agents.” These drugs prevent cancer cells from replicating by
The most common
- fatigue — 12%
- pneumonia — 7%
- shortness of breath — 6%
- respiratory tract infections — 5%
- muscle pain — 4%
In the phase 2 clinical trial,
Durvalumab (Imfinzi) is a type of immunotherapy drug that stimulates your immune system to attack cancer cells.
The FDA approved durvalumab on
Extensive stage SCLC may have spread:
- throughout the lung
- to lymph nodes on the other side of your chest
- to other body parts such as your
bone marrow
A “first-line treatment” means that it’s the first treatment for the cancer that doctors administer.
A phase 3 clinical trial found that half of the people who received durvalumab with chemotherapy lived at least 13 months compared with only 10.3 months for people who received chemotherapy alone.
The most common side effects were:
The drug trilaciclib (Cosela) was approved by the FDA on February 12, 2020 for decreasing chemotherapy-induced myelosuppression in adults with advanced SCLC when administered before platinum and etoposide chemotherapy or topotecan-containing chemotherapy.
“Myelosuppression” is when your bone marrow starts producing fewer blood cells, and it’s a common side effect of chemotherapy.
The
- fatigue
- low blood calcium
- low blood potassium
- low blood phosphate
- increase in the liver enzyme aspartate aminotransferase
- headache
- pneumonia
Three phase 2
On
The approval was based on the results of a phase 3 clinical trial called “IMpower133.” In the trial, half of the people who received atezolizumab and chemotherapy lived at least 12.3 months, but half of the people who received a placebo with chemotherapy only lived 10.3 months.
The most common side effects of atezolizumab were:
- fatigue
- weakness
- nausea
- hair loss
- constipation
- decreased appetite
The FDA granted nivolumab (Opdivo) accelerated approval as a third-line treatment, on
The approval was based on the CheckMate-032 trial. In the trial, the overall response rate was
- 6 months in 77% of people
- 12 months in 62% of people
- 18 months in 39% of people
The most common side effects in the trial were:
- fatigue
- decreased appetite
- muscle pain
- shortness of breath
- nausea
- diarrhea
- constipation
- cough
The drug JBI-802 by Jubilant Therapeutics received FDA orphan drug designation for SCLC on January 5, 2023. “Orphan drug designation” means a drug company receives financial benefits for developing a drug for a rare disease.
A phase 1 and 2 clinical trial is currently recruiting participants to examine the maximum-tolerated dose of JBI-802 and the recommended dose for people with advanced solid tumors.
According to the most recent search results from clinicaltrials.gov, more than 30 phase 3 clinical trials examining SCLC treatments are currently active or recruiting. Here’s a summary of some of the goals of these studies:
- to compare combination HLX10/chemotherapy/radiation therapy with combination chemotherapy/radiation therapy in people with limited stage SCLC
- to investigate the benefit of durvalumab or durvalumab and tremelimumab as a treatment to kill any remaining cancer cells after successful chemoradiation therapy in people with limited stage SCLC
- to compare combination lurbinectedin/atezolizumab with atezolizumab alone as maintenance therapy in people with extensive stage SCLC after first-line therapy with carboplatin, etoposide, and atezolizumab
- to compare combination atezolizumab/carboplatin/etoposide plus tiragolumab with the combination plus a placebo in people with extensive stage SCLC who haven’t received previous chemotherapy
- to compare irinotecan liposome injection with topotecan in people with SCLC with disease progression after platinum-based first-line chemotherapy
- to compare two combination treatment regimens: treatment with combination pembrolizumab/vibostolimab plus combination etoposide/platinum chemotherapy followed by another round of combination pembrolizumab/vibostolimab and treatment with combination atezolizumab/etoposide/platinum chemotherapy that is followed by atezolizumab as a first-line treatment for extensive stage SCLC
- to compare the benefit of HLX10 plus carboplatin-etoposide chemotherapy with atezolizumab and chemotherapy in previously untreated extensive stage SCLC
SCLC tends to be aggressive and has usually spread to distant body parts by the time it has been diagnosed. Researchers are continuing to examine new drugs and combinations of drugs to treat SCLC.
If your condition is diagnosed as SCLC, a doctor may recommend participating in a clinical trial that may give you access to state-of-the-art treatment.
You can find clinical studies that are currently recruiting by visiting the U.S. National Library of Medicine’s database.