[Strategy with Immune Checkpoint Inhibitors for ES‒SCLC]

As a treatment strategy for various carcinoma, immune checkpoint inhibitors(ICIs)can prolong overall survival with ICI monotherapy, ICIs combination therapy, or chemotherapy and ICI combination therapy. It has been validated in clinical trials and is recognized as a key drug in the treatment of cancer. In two large phase Ⅲ trials(IMpower133 and CASPIAN), the strategy of anti PD‒L1 antibody, such as atezolizumab and durvalumab, with chemotherapy was prolonged overall survival compared with the chemotherapy alone in extensive stage small cell lung cancer. Although attention should be paid to immune‒related adverse events, treatment discontinuation rates for adverse events in both trials were considered to be comparable to those in the chemotherapy alone group, indicating that treatment was tolerated. Currently, carboplatin plus etoposide plus atezolizumab combination therapy or platinum agent(carboplatin or cisplatin)plus etoposide plus durvalumab combination therapy is recommended grade 1A in the Guidelines for Diagnosis and Treatment of the Lung Cancer/ Malignant Pleural Mesothelioma/Thymic Tumors 2020 as the first‒line treatment for extensive stage small cell lung cancer in Japan. This article presents an overview of each clinical trials and clinical questions.