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Abstract：
Small-cell lung cancer (SCLC) is a biologically aggressive subtype of lung cancer, a lethal disease characterized by rapid tumor growth, early relapse, a strong tendency for early widespread metastasis, and high genomic instability, making it a formidable foe in modern oncology practice. While the management of non-SCLC has been revolutionized in the era of immunotherapy, progress in SCLC has been more muted. Recent randomized phase III clinical trials have combined programmed death ligand-1 inhibitors to a chemotherapy backbone and demonstrated improved survival; however, the absolute benefit observed is short months. There is an undeniable urgent need for better responses, better agents, novel therapeutic approaches, and more rational, biomarker-driven clinical trials in SCLC. In this review, we discuss the rationale and current understanding of the biology of SCLC in the modern era of immunotherapy, discuss recent advances in front-line immunotherapeutic approaches that have changed clinical practice globally, provide an overview of some of the challenges and limitations that have staggered immune checkpoint blockade in SCLC, and explore some of the novel immunotherapeutic approaches currently being investigated.
摘要：
小细胞肺癌（SCLC）是一种生物学侵袭性的肺癌亚型，一种以肿瘤快速生长为特征的致命疾病，早期复发，早期广泛转移的强烈趋势，和高度的基因组不稳定性，使其成为现代肿瘤学实践中的强大敌人。虽然非SCLC的管理在免疫治疗时代已经发生了革命性的变化，SCLC的进展更加缓慢。最近的随机III期临床试验已将程序性死亡配体-1抑制剂与化疗骨干结合，并证明了生存率的提高；然而，观察到的绝对益处是短月。不可否认，迫切需要更好的应对措施，更好的特工,新的治疗方法，更理性，生物标志物驱动的SCLC临床试验。在这次审查中,我们讨论了免疫疗法现代时代对SCLC生物学的基本原理和当前理解，讨论改变全球临床实践的一线免疫治疗方法的最新进展，概述了SCLC中交错免疫检查点阻断的一些挑战和限制，并探索目前正在研究的一些新的免疫治疗方法。
