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KEYNOTE-028: how do we use immunotherapy in small cell lung cancer?

Recently, PD-1 axis inhibition has started to show activity in small cell lung cancer (SCLC), enough to suggest that, at last, a new treatment option for SCLC may have arrived. Nivolumab and nivolumab + ipilimumab are now both listed in the NCCN guidelines for second line or beyond therapy in SCLC, based on data from the Checkmate-032 study, although neither of these regimens has yet been approved by the FDA (1). Additionally, a small phase Ib study (KEYNOTE-028) recently published in The Journal of Clinical Oncology by Ott et al . has explored the use of pembrolizumab monotherapy in previously treated extensive stage SCLC (2). The emergence of immunotherapy as a therapeutic option in SCLC is exciting, but there is still a lot to learn about its true potential in this disease.