Lungcast: Current Perspectives on Treatment of Small Cell Lung Cancer with Jacob Sands, MD

Small cell lung cancer (SCLC) remains one of the most formidable challenges in thoracic oncology. Accounting for roughly 15% of all lung cancers, SCLC is defined by its rapid growth, early metastatic potential, and high recurrence rates.1 While non–SCLC has seen transformative advances in targeted therapies and immunotherapy, SCLC has historically lagged behind, with chemotherapy and radiation long serving as the primary treatment backbone. Despite initial responses to therapy, outcomes have remained poor, with survival rates trailing far behind those seen in other lung cancer subtypes.

In recent years, however, a wave of research has begun to change this narrative. Advances in immunotherapy, novel chemotherapeutic agents, and innovative approaches such as bispecific antibodies and vaccines are reshaping treatment strategies. Landmark trials have introduced new standards of care, particularly in limited-stage disease, and ongoing studies continue to push the field toward more durable control and improved survival.2,3 The exploration of biomarkers and disease subtypes, once elusive in SCLC, is also beginning to show promise, raising the possibility of more personalized approaches to treatment.

In this episode of Lungcast, host Albert Rizzo, MD, is joined by Jacob Sands, MD, thoracic medical oncologist at Dana-Farber Cancer Institute and Associate Chief of the Lowe Center for Thoracic Oncology and Assistant Professor of Harvard Medical School, to discuss the evolving landscape of SCLC therapy. Sands, who also leads the small cell lung cancer clinical research program at Dana-Farber, shares insights into the latest therapeutic advances, the most promising investigational strategies, and why the outlook for patients with this historically intractable disease is finally beginning to brighten.

"There is more going on right now in the development of drugs for SCLC that looks encouraging, that looks exciting, than the culmination of everything up to this point so far. And the science is getting so fast that I think in the next decade ahead, we're going to see some very big advances in the field, and I'm just so optimistic looking forward now," Sands said. "If we talk in a year, there's going to be so much more to discuss."

Lungcast is a monthly respiratory news podcast series hosted by Albert Rizzo, MD, chief medical officer of the ALA, and produced by HCPLive.

Subscribe to Lungcast on Spotify here, or listen to the episode below.

Editor's Note: Rizzo's disclosures include Pfizer, AstraZeneca, and Genentech. Sands' disclosures include Pfizer, AstraZeneca, Medtronic, Daiichi Sankyo/UCB Japan, Sanofi, Boehringer Ingelheim, PharmaMar, Guardant Health, AbbVie, Gilead Sciences, Lilly, and G1 Therapeutics.

References

1. Rudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021;7(1):3. Published 2021 Jan 14. doi:10.1038/s41572-020-00235-0

2. Takahashi T, Yamanaka T, Seto T, et al. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2017;18(5):663-671. doi:10.1016/S1470-2045(17)30230-9

3. Trigo J, Subbiah V, Besse B, et al. Lurbinectedin as second-line treatment for patients with small-cell lung cancer: a single-arm, open-label, phase 2 basket trial. The Lancet Oncology. 2020;21(5):645-654. doi: 10.1016/S1470-2045(20)30068-1