Dr. Perez-Soler on Immunotherapy Advances in SCLC

Roman Perez-Soler, MD, chairman of the Department of Oncology and chief of the Division of Medical Oncology at Montefiore Medical Center, discusses recent advances made in immunotherapy for the treatment of patients with small cell lung cancer (SCLC).

Up until a few months ago, the field had gone about 20 years without any progress made, says Perez-Soler, but it seems that 2018 was the breakthrough year for SCLC. The first positive data was seen with the frontline combination of the checkpoint inhibitor atezolizumab (Tecentriq) and chemotherapy; these data are of great historical impact, notes Perez-Soler, because they are first to show any survival advantage over the standard chemotherapy for frontline treatment.

Additionally, if immunotherapy is not given frontline, there is opportunity for nivolumab (Opdivo) in the third-line. It is universal that patients will progress on topotecan, and nivolumab has shown to result in overall response rates of about 10% to 12%; these responses have proven to be durable—lasting for about 1 year—which is exceptional in SCLC, according to Perez-Soler. Based on this data, in August 2018, the FDA granted accelerated approval to nivolumab for patients with metastatic SCLC with progression after platinum-based chemotherapy and at least 1 other line of therapy.