Extensive-stage small-cell lung cancer (ES-SCLC) is an aggressive cancer that remains very hard to treat. The life expectancy of a patient diagnosed with this disease has not changed over the past three decades. Recently, three large clinical studies showed a survival benefit by adding an anti–programmed death (ligand) 1 (PD-(L)1 antibody to the current chemotherapy regimen. Although significant and important, the benefit seems less than what has been achieved in patients with non–small-cell lung cancer treated with chemoimmunotherapy. A number of hypotheses have been explored to explain this discrepancy. Here, we hypothesise that the current chemotherapy backbone in ES-SCLC does not contain the optimal drugs to trigger immunogenic cell death and therefore does not induce a synergy between chemotherapy and immune checkpoint inhibitor therapy. Thereby, we advocate that doxorubicin treatment instead of etoposide should be reconsidered as standard-of-care (SoC) first-line treatment of SCLC.

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Keywords Calreticulin, Etoposide, Immunogenic cell death, Immunologic factors, Immunotherapy, Small-cell lung cancer
Persistent URL dx.doi.org/10.1016/j.ejca.2020.06.029, hdl.handle.net/1765/129345
Journal European Journal of Cancer
Organisation Department of Pulmonology
Citation
Mankor, J.M. (Joanne M.), Zwierenga, F. (Fenneke), Dumoulin, D.W. (Daphne W.), Neefjes, J, & Aerts, J.G.J.V. (2020). A brief report on combination chemotherapy and anti–programmed death (ligand) 1 treatment in small-cell lung cancer: Did we choose the optimal chemotherapy backbone?. European Journal of Cancer, 137, 40–44. doi:10.1016/j.ejca.2020.06.029