Advances in Immunotherapy and Chemoradiotherapy Combination for Limited-Stage Small-Cell Lung Cancer: Current...

Concurrent chemoradiotherapy (cCRT) remains the standard of care for limited-stage SCLC (LS-SCLC), while long-term survival remains suboptimal. This review aims to summarize recent advances in combining immunotherapy with cCRT in LS-SCLC and highlight future directions in this evolving treatment landscape.

The ADRIATIC trial demonstrated significant improvements in overall survival (OS) and progression-free survival (PFS) with durvalumab consolidation post-concurrent chemoradiotherapy (cCRT). Other studies explore various immunotherapeutic agents and combination strategies, underscoring the potential of PD-1/PD-L1 blockade and other novel targets such as BTLA and TIGIT in the treatment of LS-SCLC. However, challenges remain in determining the appropriate timing of immunotherapy and the optimal radiotherapy fraction schedule, as well as the role of prophylactic cranial irradiation (PCI) in the context of immunotherapy. Integrating immunotherapy into LS-SCLC treatment represents a promising strategy with the potential to improve outcomes beyond what is achievable with cCRT alone. Ongoing trials are expected to provide further insights, potentially reshaping LS-SCLC treatment strategies.