The Oncology Forum: Expert Panel Shares Insights on Key SCLC Updates

Sanjay Juneja, MD, partnered with Formedics to host the Oncology Forum during the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, kicking off the robust discussion with the lung cancer panel.

The expert panel featured Stephen Liu, MD, of Georgetown University, Millie Das, MD, of Stanford University, and Eric Singhi, MD, of the University of Texas MD Anderson Cancer Center.

Dr. Juneja initiated the conversation with an intensive discussion about key updates in the field of small cell lung cancer (SCLC), highlighting recent primary results of a study of lurbinectedin plus atezolizumab as a first-line maintenance therapy for patients with extensive-stage SCLC.

I’m one of the authors of this [study],” Dr. Liu said. “Lurbinectedin [was] approved in the US in the second-line setting after first-line treatment for SCLC in the advanced stage. This is an alkylating agent. It’s a transcription inhibitor and an active drug, and the question is, if we give it earlier, does it help patients?”

Dr. Liu highlighted that although the investigators are “confident” the research will achieve a response in patients, the median progression-free survival rate of 4 months means “people progress right after or during chemotherapy.” Despite immunotherapy improving survival for some patients in the study, “most patients” will still relapse.

“We also know that at the time of relapse, a large number of patients do not receive any further therapy because it is an unforgiving process,” Dr. Liu explained. “It’s a devastating event progression, and about 50% of people will get second-line therapy, so that’s huge attrition.”

Dr. Liu further explained that these findings prompted the question, does providing this therapy earlier help patients live longer? The results revealed that it did.

“We saw this extended survival, and I think that’s not something you can dismiss,” Dr. Liu said. “By moving therapy earlier, people live longer.”

Dr. Singhi also expressed his excitement for the results, emphasizing that “any big change that we can have for patients with SCLC is huge.”

“We haven’t been able to see a maintenance benefit like this, and this is the first really recent benefit in the setting,” Dr. Singhi said. “We have to be very mindful of the toxicity and tolerability of this because now we’re taking away the opportunity for a chemotherapy-free interval—that chemotherapy break that patients wait for after they get their chemoimmunotherapy. So, we have to be very vigilant about the toxicity. We have to make sure that they can get onto another subsequent line of therapy if they need it.”

Dr. Das responded as well, stating that for patients with SCLC, it’s all about balance.

“In the maintenance setting, it’s tricky,” she said. “You’re not necessarily going to be making [patients] feel better. In fact, you might be making them feel worse, and it’s trickier in these small cell patients than in non–small cell [patients]. It’s going to be a discussion, and it’s going to be something we talk about that may not be for every patient.”