Maintenance Immunotherapy for Extensive-Stage Small-Cell Lung Cancer

Response to platinum-based chemotherapy in extensive-stage small-cell lung cancer (ES-SCLC) is brisk but often short-lived, and outcomes remain dismal. Over the last 2 years, we have witnessed improvement in overall survival, albeit modest, with the addition of anti–programmed death ligand-1 antibody (PDL1) therapies to platinum-etoposide doublet therapy in the front-line management of ES-SCLC, establishing a new standard of care. Prior to the FDA approval of atezolizumab — and more recently, durvalumab — in the first-line setting, standard-of-care therapy included 4 to 6 cycles of platinum doublet therapy followed by observation.

The CheckMate 451 trial evaluated the role of maintenance immunotherapy following 3 to 4 cycles of chemotherapy …