How is small cell lung cancer research evolving? Dr. Tejas Patil, a researcher and lung cancer specialist, discusses the recent advances in small cell lung cancer treatment, explains the impact of clinical trial participation, and shares why he is hopeful for the future of care. 

Dr. Tejas Patil is an Assistant Professor of Thoracic Oncology at the University of Colorado Cancer Center focused on targeted therapies and novel biomarkers in lung cancer. Learn more about Dr. Patil.

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Transcript:

Jamie: 

And are there emerging treatments that are showing promise for small cell lung cancer care? 

Dr. Tejas Patil: 

There are. So small cell lung cancer has some new treatments, specifically new immunotherapies that are called DLL3 T-cell engagers. The FDA has approved one of these called tarlatamab-dlle (Imdelltra), and there are several clinical trials underway looking at using these new treatments for small cell. We have been a participant in some of the clinical trials involving DLL3-targeted immunotherapy treatments, and the results have been remarkable.  

In general, I’m an advocate that patients with small cell lung cancer participate in clinical trials when possible. Our ability to develop new and groundbreaking treatments is really dependent on collective action.   

Jamie: 

Sure. I know some patients may be hesitant to join a trial. Sometimes that may be something scary. What do you tell patients that may be hesitant to participate?  

Dr. Tejas Patil: 

Clinical trials, in my view, offer the best opportunity for patients to receive cutting-edge treatment. A common question I get as a treating physician is whether I will receive a placebo if I’m on a clinical trial. The short answer is it is unethical to give patients placebo if there is a standard-of-care treatment option available. So, in most cases, patients will either receive the experimental drug, this is called an open-label clinical trial, where both the patient and the doctor know what they’re getting.

Or they might get a double-blind randomized clinical trial, in which case the doctor doesn’t know what the patient’s getting. But what we do know is that the patient will get either the standard of care, whatever that is for the disease state or the standard of care, plus some new treatment. And that is the only ethical way to design clinical trials in the first-line, second-line, or later-line setting. So clinical trials also allow us to advance the field because it allows us to offer treatments that wouldn’t otherwise be available commercially.  

Jamie: 

Dr. Patil, how’s the field of small cell lung cancer care progressing? Are you hopeful?  

Dr. Tejas Patil: 

I’m very hopeful for small cell lung cancer. I think in the last two years, I’ve seen some of the biggest therapeutic advances in this area that I’ve seen for almost 20 years. The DLL3 T-cell bispecifics, these are a new form of immunotherapy, have really been game-changers in small cell lung cancer. There’s a lot of exciting clinical trials in small cell lung cancer.   

It’s a disease that has been very difficult to treat for many years with traditional chemotherapies. And what I’m very excited about is that we are trying to think of newer ways to treat small cell lung cancer. We’re using new immunotherapies, there’s going to be radio ligand therapy in the future. There’s novel molecular profiling of small cell that’s helping us figure out which types of subsets of small cell might be better suited to different types of therapies. And I also want to emphasize that the other big advance in small cell lung cancer has been lung cancer screening. We are actually catching small cell at an earlier and earlier stage, which makes it even more likely for us to cure small cell lung cancer.