Small Cell Lung Cancer in Transition: Recent Advances in Biology, Treatment, and Precision Medicine

Abstract

Simple Summary Small cell lung cancer is one of the fastest-growing and most difficult lung cancers to treat. It often spreads early, responds well at first to chemotherapy and radiation, but usually returns and becomes resistant to treatment. This review summarizes recent advances in understanding the disease and improving patient care. The most important changes include adding immune-based treatment to chemotherapy for widespread disease, using durvalumab after combined chemotherapy and radiation for disease limited to the chest, and introducing tarlatamab for cancer that has returned after prior treatment. Tarlatamab works by helping immune cells recognize and attack cancer cells. Researchers are also studying blood-based tests that detect tumor material, molecular subtypes of the disease, and other markers that may help predict treatment response. Despite these advances, long-term survival remains poor, and challenges such as treatment resistance, spread to the brain, side effects, and the lack of reliable predictive tests remain. Continued research is needed to select treatments more precisely, detect relapse earlier, and achieve longer-lasting disease control for patients.