Can Maintenance Therapy Help Extend Response in Extensive-Stage Small Cell Lung Cancer?

Sponsored Content by Jazz Pharmaceuticals

This information is intended for US health care professionals only.

Small cell lung cancer (SCLC) is one of the most aggressive and difficult-to-treat forms of lung cancer. In the US, approximately 30,000 new cases of SCLC are diagnosed each year. Among patients diagnosed with SCLC, approximately 70% have already progressed to extensive-stage disease (ES-SCLC), meaning the cancer has spread beyond 1 lung and nearby lymph nodes.1,2 Unfortunately, only 1 out of 5 people survives longer than 2 years. While many patients with ES-SCLC initially respond to platinum-based chemotherapy—with or without immunotherapy—relapse is common and typically occurs within months. More than 90% of patients with metastatic ES-SCLC experience disease progression within two years.3-6

These outcomes underscore the need to explore strategies that might help sustain the benefit of initial treatment. Among the areas of active clinical investigation is how best to manage the maintenance period after first-line therapy (also known as induction therapy), a phase in which many patients face rapid disease progression. Some approaches under study aim to extend response or delay relapse by intervening during this window of stability.7

Importantly, real-world data show that only about 40% of patients who receive first-line treatment for ES-SCLC go on to receive second-line therapy.8,9* This reinforces the importance of maximizing disease control during the initial phases of treatment, when patients are most likely to be eligible for further intervention.

A Closer Look at the Role of Maintenance

Unlike other cancers where maintenance therapy is routinely used, ES-SCLC has limited maintenance therapy options after first-line treatment. After completing initial therapy, many patients are monitored until clinical or radiographic progression occurs. In a disease known for its aggressive nature and early relapse, this period of stability may offer a critical window to sustain response and delay disease progression.7

Clinical trials are now investigating whether maintenance therapy can help address this challenge by extending the duration of clinical response or disease stability while preserving quality of life. In these studies, eligibility often depends on treatment response, performance status, and tolerability. Evidence is emerging that supports continued treatment during the maintenance phase, and interest is growing in the potential of proactive treatment approaches during this high-risk phase.7

Additionally, quality of life has become an increasingly important consideration in cancer care planning. For patients with ES-SCLC, maintaining symptom control, reducing hospitalization, and extending time to disease progression are all critical goals. Maintenance therapy could offer a path to address these priorities, but only if efficacy and safety can be demonstrated in clinical trials.7

Understanding the Treatment Landscape in ES-SCLC

The development of maintenance therapies also highlights the importance of timing in ES-SCLC management. Researchers are increasingly exploring how to intervene during remission or stability, rather than waiting for progression, to help shift the trajectory of care in a disease known for rapid relapse and poor long-term outcomes.7

Jazz Pharmaceuticals supports ongoing efforts to deepen the scientific understanding of SCLC, with a focus on areas of high unmet need in extensive-stage disease. Through research and education, the company is contributing to the evolving conversation around emerging approaches to care during and after initial treatment.

With evolving scientific understanding of maintenance therapy in ES-SCLC,7 there is shift in how the oncology community can think about disease control and management. As new evidence emerges, it may help define a clearer role for continued therapy in this setting, potentially offering patients more time without disease progression and a more proactive approach to care.

* SHS claims data ending September 2024; Tx Onc data ending October 2024; Onmark Unity Data ending October 2024; IntrinsiQ ION data ending October 2024.

References

1. Porte M, Vaudron A, Crequit P, et al. A multicenter study assessing the real-world use and effectiveness of first-line chemotherapy plus immunotherapy in advanced small-cell lung cancer (SCLC) patients. Clin Lung Cancer. 2024;25(2):e101-e111.e2. doi:10.1016/j.cllc.2023.11.009
2. Byers LA, Rudin CM. Small cell lung cancer: where do we go from here? Cancer. 2015;121(5):664-672. doi:10.1002/cncr.29098
3. Saida Y, Watanabe S, Kikuchi T. Extensive-stage small-cell lung cancer: current landscape and future prospects. Onco Targets Ther. 2023;16:657-671. doi:10.2147/OTT.S272552
4. Anglin A. Extensive-stage small-cell lung cancer: hope is on the horizon. Presented at: Advanced Practice Providers Oncology Summit. October 11, 2023. https://apponcologysummit.org/extensive-stage-small-cell-lung-cancer-hope-is-on-the-horizon/#:~:text=Staging%20for%20SCLC%20is%20typically,will%20develop%20brain%20metastases%20later
5. Karacz CM, Yan J, Zhu H, Gerber DE. Timing, sites, and correlates of lung cancer recurrence. Clin Lung Cancer. 2020;21(2):127-135.e3. doi:10.1016/j.cllc.2019.12.001
6. Rudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021;7(1):3. doi:10.1038/s41572-020-00235-0
7. Paz-Ares L, Gupta B, Baena J, Liu SV. Unmet needs in maintenance therapy for extensive stage small cell lung cancer. Clin Lung Cancer. 2025;26(3):168-178. doi:10.1016/j.cllc.2025.02.015
8. Cramer-van der Welle CM, Schramel FMNH, van Leeuwen AS, Groen HJM, van de Garde EMW; Santeon SCLC Study Group. Real-world treatment patterns and outcomes of patients with extensive disease small cell lung cancer. Eur J Cancer Care (Engl). 2020;29(5):e13250. doi:10.1111/ecc.13250
9. Data on file-REF- 21246. Palo Alto, CA: Jazz Pharmaceuticals, Inc.
10. National Cancer Institute. Small cell lung cancer treatment (PDQ®)–Health professional version. Accessed March 25, 2025.