S18 Ep12: Treat Early and Aggressively: Optimizing Small Cell Lung Cancer Management Across the Community Setting: With Joshua Sabari, MD

Small cell lung cancer requires aggressive, rapid intervention due to its high mortality and rapid progression, with diagnosis and staging ideally occurring within 48 to 72 hours. Dr. Joshua K. Sabari of NYU Langone Health highlights that significant attrition between therapy lines—reaching up to 60% in community settings—demands prioritizing the most effective treatments in the frontline setting. While novel therapies like T-cell engagers and antibody-drug conjugates offer promise, they introduce complex toxicities, including cytokine release syndrome and neurotoxicity, which often exceed the resources of community practices. Successful management hinges on multidisciplinary coordination, specifically integrating thoracic pharmacists to monitor patients and mitigate adverse events. As the field moves toward biomarker-driven selection, community clinicians must adapt to these evolving biological insights and specialized support structures to improve patient outcomes.