Abstract
The state - of the art on SCLC imunotherapy is presented. Those are tumours of neuroendocrine origin, mainly affecting smokers, most frequently diagnosed in advanced stages.
Initialy, these tumours are chemosensitive, later they become resistant to majority of drugs. SCLC are recently classified as molecular subtypes ASCL1, NEUROD, POU2F3 and YAP1 which are differently sensitive to therapeutic options.
Recently, combinations of first-line chemotherapy and immunoocologic drugs atezolizumab or durvalumab brings significant survival benefit if compared with chemotherapy alove. Nivolumab and pembrolizumab are recently approved in SCLC therapy as 3th or later lines.
Positive predictive value should have probably investigation of TMB (tumour mutation burden) more than PD-L1 expression. Combination of imunooncologic drugs and chemotherapy brings significant benefit of survival and quality of life particularly in first line in combination with chemotherapy, should be also benefitial in 3rdand later therapeutic line.