Abstract
Small-cell lung cancer is an aggressive malignancy with poor clinical outcomes, especially for patients diagnosed with extensive stage disease. Historically, platinum-based chemotherapy was the standard of care, which provided an overall survival of 9–11 months.1 Since the 1980s, many attempts were made to improve upon the platinum-doublet without success until 2018, when the addition of immunotherapy to chemotherapy increased overall survival in two large, randomised clinical trials.2–3 The first trial, IMpower133,2 tested the addition of the PD-L1 inhibitor atezolizumab to platinum-based chemotherapy, which improved median overall survival from 10·3 months (95% CI 9·3–11·3) to 12·3 months (10·8–15·9; hazard ratio [HR] 0·70 [95% CI 0·54–0·91]).
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