New hope is emerging for people facing small cell lung cancer. Dr. Erin Schenk explains how treatment options have expanded—from traditional chemotherapy and radiation to newer immunotherapies that help the body fight cancer more effectively. Dr. Schenk discusses cutting-edge advances and the latest strategies that are giving patients more options than ever before.
Dr. Erin Schenk is a medical oncologist, lung cancer researcher, and associate professor in the Division of Medical Oncology at the University of Colorado Anschutz Medical Center. Learn more about Dr. Schenk.
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Transcript
Katherine Banwell:
Dr. Schenk, what are the currently approved treatment options for small cell lung cancer?
Dr. Erin Schenk:
Small cell lung cancer has experienced a recent growth in terms of different therapies available at different stages of the disease. So, patients who have limited stage small cell lung cancer are usually treated with a combination of chemotherapy medicines and radiation. Those are given together.
And after completion of the chemotherapy and the radiation together, we next give an immune checkpoint inhibitor or an immunotherapy to help reduce the risk of the cancer coming back.
So, within that stage of disease, an earlier stage disease, those are new therapies. For patients with cancer that’s spread outside the lungs or to the other lung, from the right to the left, we do have additional therapies for patients in that situation, too, where they have what we term extensive stage small cell lung cancer.
One approach is to add some additional chemotherapy medicines. So, what I mean by that is, patients usually receive a combination of two chemotherapies, a platinum agent, so carboplatin (Paraplatin) and cisplatin (Platinol), plus etoposide (Vepesid). Those are the chemotherapies we usually give. And then, patients also receive an immunotherapy or a checkpoint inhibitor with those two chemotherapies.
What we’ve recently learned is, after giving some of those initial chemotherapy medicines, when patients transition to just the checkpoint inhibitor or the immunotherapy alone, we’re also able to give a new chemotherapy called lurbinectedin (Zepzelca). And this chemotherapy plus the immunotherapy is able to reduce the risk of the cancer coming back. If the cancer does come back, so if a patient with extensive stage small cell lung cancer, after the first set of medicines, experiences the cancer coming back, we do have a brand-new medicine that’s available to patients called tarlatamab-dlle (Imdelltra).
Tarlatamab is a really new type of medicine for us taking care of patients with lung cancer. I like to describe it as a medicine with two sticky ends. I have small kids at home, and they love those sticky hands that you can sort of extend out, and they stick to things and pull back.
Well, tarlatamab is a medicine that binds to or grabs onto a certain marker on the top of the cancer cell, DLL3.
So, it sticks to DLL3. And then, the other end of the medicine sticks to one of the major cells of the immune system, the T cell. And what happens is that this medicine brings those immune cells towards the cancer cell to help encourage the immune cells to recognize and eliminate the cancer cells. That’s now available for patients who need a new set of treatments after the first treatment approach is no longer helpful.