Small Cell Lung Cancer — Proceedings from a Session Held in Conjunction with the 2026 ASCO Annual Meeting

Small cell lung cancer management has entered a transformative era, shifting from traditional chemotherapy to advanced chemo-immunotherapy and targeted strategies. First-line extensive-stage treatment now centers on chemo-immunotherapy, with maintenance options like lurbinectedin demonstrating significant progression-free and overall survival benefits. In the relapsed/refractory setting, Tarlatumab—a DLL3-targeted bispecific T-cell engager—has emerged as a game-changer, offering durable responses despite risks of cytokine release syndrome and neurotoxicity. Concurrently, antibody-drug conjugates targeting B7H3 and TROP2 are showing promise, particularly for patients with brain metastases. For limited-stage disease, concurrent chemoradiation followed by two years of maintenance durvalumab has established a new standard, pushing median overall survival to unprecedented levels. Clinical decision-making now requires balancing these potent, novel therapies with careful management of unique side effect profiles and patient-specific factors like performance status and paraneoplastic syndromes.