Second Opinion: Investigators Provide Perspectives on the Current and Future Management of Small Cell Lung Cancer — Symposium Proceedings

Faculty

TARGET AUDIENCE
This activity is intended for medical oncologists, hematologists, hematology-oncology fellows, radiation oncologists, surgeons and other allied healthcare professionals involved in the treatment of lung cancer.

LEARNING OBJECTIVES

• Appraise available findings from clinical studies investigating anti-PD-1/PD-L1 antibody consolidation therapy for patients with limited-stage small cell lung cancer (SCLC) who have not experienced disease progression after standard platinum-based chemotherapy concurrent with radiation therapy, and determine the clinical role of this approach.
• Review long-term data supporting the use of anti-PD-1/PD-L1 antibodies in combination with platinum-based chemotherapy as first-line therapy for patients with extensive-stage SCLC, and consider how these regimens can be appropriately and safely integrated into clinical practice.
• Appreciate the biological rationale for the evaluation of maintenance treatment after chemoimmunotherapy induction, and assess available research findings with and the current role of this approach.
• Evaluate available clinical trial findings with FDA-approved agents for patients with SCLC who experience disease progression on or after platinum-containing first-line therapy, and determine how to optimally integrate these therapies into current treatment algorithms.
• Interrogate published clinical trial data with DLL3-directed T-cell engager therapy for SCLC, and identify patients with relapsed/refractory (R/R) disease appropriate for this novel approach.
• Appreciate the incidence of B7-H3 overexpression in patients with SCLC, and develop an understanding of the rationale for, available data with and ongoing studies of B7-H3-directed antibody-drug conjugates for R/R disease.
• Reflect on the biological rationale for the evaluation of TROP2-directed antibody-drug conjugates for SCLC, and consider available research findings and ongoing studies with these agents.
• Assess ongoing clinical research studies evaluating other novel agents and treatment strategies for SCLC, and counsel patients regarding the potential benefits of trial participation.

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CREDIT DESIGNATION STATEMENT
Research To Practice designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
Successful completion of this CME activity, which includes participation in the evaluation component and a post-test, enables the participant to earn up to 2.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

AMERICAN BOARD OF SURGERY (ABS) — CONTINUOUS CERTIFICATION (CC)
Successful completion of this CME activity, which includes participation in the evaluation component and a post-test, enables the learner to earn credit toward the CME and Self-Assessment requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABS credit.

Please note, this program has been specifically designed for the following ABS practice area: complex general surgical oncology.

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HOW TO USE THIS CME ACTIVITY
To receive credit for this activity, the participant should review the CME information, watch the video, complete the post-test with a score of 80% or better, and fill out the evaluation.

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Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education and adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of an accredited continuing education activity, including faculty, planners, reviewers and others, are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant financial relationships have been mitigated prior to the commencement of this activity. In addition, all activity content is reviewed by RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty reported relevant financial relationships with ineligible entities:

Dr Chiang — Advisory Committees: AbbVie Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Daiichi Sankyo Inc, Genentech, a member of the Roche Group, Janssen Biotech Inc, Merck, Zai Lab; Consulting Agreements: AbbVie Inc, Merck; Contracted Research: AbbVie Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bristol Myers Squibb, Genentech, a member of the Roche Group, Zai Lab; Data and Safety Monitoring Boards/Committees: AstraZeneca Pharmaceuticals LP; Honoraria for Lectures: Genentech, a member of the Roche Group, Jazz Pharmaceuticals Inc. Dr Ganti — Advisory Committees: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Catalyst Pharmaceuticals Inc, Fosun Pharma, Merck, Pfizer Inc, Zai Lab; Consulting Agreements: Cardinal Health, Jazz Pharmaceuticals Inc; Contracted Research: Imugene, Iovance Biotherapeutics, Merck, Mirati Therapeutics Inc, Poseida Therapeutics. Dr Paz-Ares — Advisory Committees: Abbott, AbbVie Inc, Amgen Inc, Astellas, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol Myers Squibb, Daiichi Sankyo Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Merck, Novartis, Pfizer Inc, Regeneron Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Pharmaceuticals USA Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol Myers Squibb, MSD, Pfizer Inc; Board Memberships: Altum Sequencing, STAb Therapeutics.

CONTRIBUTING CLINICAL INVESTIGATORS
Charu Aggarwal, MD — Consulting Agreements: AstraZeneca Pharmaceuticals LP, Daiichi Sankyo Inc, Genmab US Inc, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck. Ticiana Leal, MD — Advisory Committees: Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Catalyst Pharmaceuticals Inc, Gilead Sciences Inc, Jazz Pharmaceuticals Inc, Johnson & Johnson, Merck, Molecular Partners, Novocure Inc, Nuvation Bio Inc, Roche Laboratories Inc, Summit Therapeutics, Synthekine, Verastem Inc; Consulting Agreements: AbbVie Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Catalyst Pharmaceuticals Inc, Gilead Sciences Inc, Jazz Pharmaceuticals Inc, Johnson & Johnson, Lilly, Molecular Partners, Novocure Inc; Contracted Research (to Institution): Daiichi Sankyo Inc; Data and Safety Monitoring Boards/Committees: OncoC4; Travel Support: Amgen Inc, Novocure Inc.

MODERATOR — Dr Shields — Steering Committees: AstraZeneca Pharmaceuticals LP.

EDITOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following companies: Aadi Bioscience, AbbVie Inc, ADC Therapeutics, Agendia Inc, Alexion Pharmaceuticals, Amgen Inc, Array BioPharma Inc, a subsidiary of Pfizer Inc, Arvinas, Astellas, AstraZeneca Pharmaceuticals LP, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, BeOne, Biotheranostics Inc, A Hologic Company, Black Diamond Therapeutics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Bristol Myers Squibb, Catalyst Pharmaceuticals Inc, Celcuity, Clovis Oncology, Coherus BioSciences, Corcept Therapeutics Inc, CTI BioPharma, a Sobi Company, Daiichi Sankyo Inc, Eisai Inc, Elevation Oncology Inc, Exact Sciences Corporation, Exelixis Inc, Genentech, a member of the Roche Group, Genmab US Inc, Geron Corporation, Gilead Sciences Inc, GSK, Helsinn Therapeutics (US) Inc, ImmunoGen Inc, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Jazz Pharmaceuticals Inc, Johnson & Johnson, Karyopharm Therapeutics, Kite, A Gilead Company, Kura Oncology, Legend Biotech, Lilly, MEI Pharma Inc, Merck, Mersana Therapeutics Inc, Mirati Therapeutics Inc, Mural Oncology Inc, Natera Inc, Novartis, Novartis Pharmaceuticals Corporation on behalf of Advanced Accelerator Applications, Novocure Inc, Nuvalent, Nuvation Bio Inc, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Revolution Medicines Inc, Rigel Pharmaceuticals Inc, R-Pharm US, Sanofi, Seagen Inc, Servier Pharmaceuticals LLC, SpringWorks Therapeutics Inc, Stemline Therapeutics Inc, Sumitomo Pharma America, Summit Therapeutics, Syndax Pharmaceuticals, Taiho Oncology Inc, Takeda Pharmaceuticals USA Inc, TerSera Therapeutics LLC, Tesaro, A GSK Company, and Verastem Inc.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant financial relationships to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

This activity is supported by educational grants from Amgen Inc, AstraZeneca Pharmaceuticals LP, Daiichi Sankyo Inc, Gilead Sciences Inc, Jazz Pharmaceuticals Inc, and Merck.

Release date: August 2026
Expiration date: August 2027

After completing the post-test, learners may download and review the answers here in order to identify further areas of study.

Dr Shields

Ahn M-J et al. Tarlatamab for patients with previously treated small-cell lung cancer. N Engl J Med 2023;389(22):2063-75. Abstract

Dowlati A et al. Phase 2 open-label study of sacituzumab govitecan as second-line therapy in patients with extensive-stage SCLC: Results from TROPiCS-03. J Thorac Oncol 2025;20(6):799-808. Abstract

Mountzios G et al. Tarlatamab in small-cell lung cancer after platinum-based chemotherapy. N Engl J Med 2025;393(4):349-61. Abstract

Paulson KG et al. Safety and activity of tarlatamab in combination with a PD-L1 inhibitor as first-line maintenance therapy after chemo-immunotherapy in patients with extensive-stage small-cell lung cancer (DeLLphi-303): A multicentre, non-randomised, phase 1b study. Lancet Oncol 2025;26(10):1300-11. Abstract

Paz-Ares L et al. Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): A randomised, multicentre, open-label, phase 3 trial. Lancet 2025;405(10495):2129-43. Abstract

Reck M et al. Five-year survival in patients with extensive-stage small cell lung cancer treated with atezolizumab in the phase III IMpower133 study and the phase III IMbrella A extension study. Lung Cancer 2024;196:107924. Abstract

Rudin CM et al. Ifinatamab deruxtecan in patients with extensive-stage small cell lung cancer: Primary analysis of the phase II IDeate-Lung01 trial. J Clin Oncol 2026;44(4):261-73. Abstract

Trigo J et al. Lurbinectedin as second-line treatment for patients with small-cell lung cancer: A single-arm, open-label, phase 2 basket trial. Lancet Oncol 2020;21(5):645-54. Abstract

Dr Paz-Ares

Ahn M-J et al. Tarlatamab for patients with previously treated small-cell lung cancer. N Engl J Med 2023;389(22):2063-75. Abstract

Ai X et al. A phase 2 dose expansion study of ZG006, a trispecific T cell engager targeting CD3/DLL3/DLL3, as monotherapy in patients with advanced small cell lung cancer. ASCO 2025;Abstract 8007.

Beltran H et al. Updated results from a phase 1/2 study of HPN328, a tri-specific, half-life (T1/2) extended DLL3-targeting T-cell engager in patients (pts) with small cell lung cancer (SCLC) and other neuroendocrine cancers (NEC). ASCO 2024;Abstract 8090.

Mountzios G et al. Tarlatamab in small-cell lung cancer after platinum-based chemotherapy. N Engl J Med 2025;393(4):349-61. Abstract

Paz-Ares LG et al. Efficacy and safety of lurbinectedin (LUR) with irinotecan (IRI) in patients (Pts) with relapsed small cell lung cancer (SCLC): Results from a phase 2 expansion cohort. ASCO 2024;Abstract 8094.

Ponce S et al. Combination of lurbinectedin plus irinotecan: Preclinical and early clinical results in patients with relapsed SCLC. J Thorac Oncol 2026;21(7):103654. Abstract

Ponce Aix S et al. Safety and efficacy of lurbinectedin plus atezolizumab as second-line treatment for advanced small-cell lung cancer: Results of the 2SMALL phase 1/2 study (NCT04253145). ASCO 2025;Abstract 8013.

Ponce Aix S et al. Combination lurbinectedin and doxorubicin versus physician’s choice of chemotherapy in patients with relapsed small-cell lung cancer (ATLANTIS): A multicentre, randomised, open-label, phase 3 trial. Lancet Respir Med 2023;11(1):74-86. Abstract

Trigo J et al. Lurbinectedin as second-line treatment for patients with small-cell lung cancer: A single-arm, open-label, phase 2 basket trial. Lancet Oncol 2020;21(5):645-54. Abstract

Wermke M et al. DAREON-9, a phase Ib study of obrixtamig plus topotecan in patients (pts) with advanced small cell lung cancer (SCLC): Interim analysis results. ASCO 2025;Abstract 8094.

Dr Chiang

Dowlati A et al. Phase 2 open-label study of sacituzumab govitecan as second-line therapy in patients with extensive-stage SCLC: Results from TROPiCS-03. J Thorac Oncol 2025;20(6):799-808. Abstract

Patel MR et al. ZL-1310, a DLL3 ADC, in patients with extensive stage small cell lung cancer: Ph1 trial update. ASCO 2025;Abstract 3041.

Rudin CM et al. Ifinatamab deruxtecan in patients with extensive-stage small cell lung cancer: Primary analysis of the phase II IDeate-Lung01 trial. J Clin Oncol 2026;44(4):261-73. Abstract

Simoes da Rocha PF et al. Intracranial activity of ifinatamab deruxtecan (I-DXd) in patients (pts) with extensive-stage (ES) small cell lung cancer (SCLC) and baseline (BL) brain metastases (BM): Primary analysis of IDeate-Lung01. ESMO 2025;Abstract 2760MO.

Dr Ganti

Bogart J et al. High-dose once-daily thoracic radiotherapy in limited-stage small-cell lung cancer: CALGB 30610 (Alliance)/RTOG 0538. J Clin Oncol 2023;41(13):2394-402. Abstract

Cheng Y et al. Durvalumab after chemoradiotherapy in limited-stage small-cell lung cancer. N Engl J Med 2024;391(14):1313-27. Abstract

Mountzios G et al. Tarlatamab in small-cell lung cancer after platinum-based chemotherapy. N Engl J Med 2025;393(4):349-61. Abstract

Walls GM et al. Long-term outcomes after concurrent once- or twice-daily chemoradiation in limited-stage small cell lung cancer: A brief report from the CONVERT trial. Int J Radiat Oncol Biol Phys 2024;119(5):1386-90. Abstract