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Background <p>Small cell lung cancer (SCLC) is an aggressive pulmonary tumor entity and accounts for approximately 15% of all lung cancers. The TNM classification enables a&#xa0;more precise prognostic assessment and treatment planning.</p> Objective <p>The aim was to outline the stage-dependent treatment principles of SCLC and recent developments in first-line, maintenance, and relapse therapy.</p> Material and methods <p>A narrative review of current guidelines and clinical studies on localized and metastatic SCLC is presented.</p> Results <p>In stages I/II treatment includes surgery, adjuvant platinum-based chemotherapy and, if indicated, mediastinal radiotherapy as well as prophylactic cranial irradiation (PCI). In stage&#xa0;III, concurrent chemoradiotherapy with PCI represents the standard of care and consolidation with durvalumab for 2 years improves survival. In stage&#xa0;IV immunochemotherapy followed by maintenance immunotherapy is the current first-line standard. Intensified maintenance with atezolizumab and lurbinectedin showed a&#xa0;moderate improvement in progression-free and overall survival in one study. Novel immunotherapeutic approaches, such as the T‑cell engager tarlatamab show promising results and could change the second-line treatment of SCLC. Antibody-drug conjugates targeting DLL3, B7-H3, SEZ6, or TROP2 demonstrate promising activity in early studies. Additional targeted and epigenetic approaches are under clinical investigation.</p> Conclusion <p>The integration of immunotherapy has improved the treatment of SCLC, although the prognosis remains unfavorable. Emerging strategies such as T‑cell engagers and antibody-drug conjugates could enable other therapeutic advances in the future.</p>

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Therapieprinzipien beim kleinzelligen Lungenkarzinom

  • 期刊论文

  • 发表日期：

    2026年5月27日

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  • Cornelia Kropf-Sanchen

摘要

Background

Small cell lung cancer (SCLC) is an aggressive pulmonary tumor entity and accounts for approximately 15% of all lung cancers. The TNM classification enables a more precise prognostic assessment and treatment planning.

Objective

The aim was to outline the stage-dependent treatment principles of SCLC and recent developments in first-line, maintenance, and relapse therapy.

Material and methods

A narrative review of current guidelines and clinical studies on localized and metastatic SCLC is presented.

Results

In stages I/II treatment includes surgery, adjuvant platinum-based chemotherapy and, if indicated, mediastinal radiotherapy as well as prophylactic cranial irradiation (PCI). In stage III, concurrent chemoradiotherapy with PCI represents the standard of care and consolidation with durvalumab for 2 years improves survival. In stage IV immunochemotherapy followed by maintenance immunotherapy is the current first-line standard. Intensified maintenance with atezolizumab and lurbinectedin showed a moderate improvement in progression-free and overall survival in one study. Novel immunotherapeutic approaches, such as the T‑cell engager tarlatamab show promising results and could change the second-line treatment of SCLC. Antibody-drug conjugates targeting DLL3, B7-H3, SEZ6, or TROP2 demonstrate promising activity in early studies. Additional targeted and epigenetic approaches are under clinical investigation.

Conclusion

The integration of immunotherapy has improved the treatment of SCLC, although the prognosis remains unfavorable. Emerging strategies such as T‑cell engagers and antibody-drug conjugates could enable other therapeutic advances in the future.