Oncology Today with Dr Neil Love Extensive-Stage Small Cell Lung Cancer — Current Patterns of Care with First-Line and Maintenance Therapy
Feb 27, 2026
Dr Anne Chiang, Yale medical oncologist focused on translational SCLC research, and Dr Hossein Borghaei, Fox Chase clinical investigator in lung cancer trials, discuss first-line immunotherapy plus chemotherapy, maintenance strategies including lurbinectedin and tarlatimab, real-world case decisions, biomarkers and molecular subtypes, and emerging trials shaping future front-line and maintenance approaches.
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Immunotherapy Produces A Five-Year Survival Tail
- Immunotherapy created a new tail in survival for extensive-stage small cell, with roughly 10–15% of patients alive at five years.
- Anne Chiang and Dr Neil Love reported institutional and literature data showing about 12% five-year overall survival after adding checkpoint inhibitors to chemo.
Offer Lurbinectedin With Atezolizumab For Maintenance
- Use lurbinectedin plus atezolizumab as a maintenance option for patients who recover after induction chemo plus IO, based on M4T/INFORTE results showing PFS and OS benefit from randomization point.
- Expect added myelosuppression and fatigue; only ~9% of control-arm patients received lurbinectedin later in the trial, so benefit may be greatest when given in maintenance.
Discuss Maintenance Early And Time It With Recovery
- Discuss maintenance options and toxicities with patients early during induction so they can prepare for potential additional treatment.
- In the presented 60-year-old case, delaying lurbinectedin until recovery then starting it led to continued disease control while managing fatigue and myelosuppression.