Carcinoma de pulmón de célula pequeña: reporte de un caso con respuesta clínica completa al tratamiento con quimioinmunoterapia

Introduction: Small cell lung carcinoma (SCLC) accounts for 15% of lung cancer cases. It is classified as extensive stage (ES-SCLC) when there is metastasis or if the volume of disease cannot be covered in a single radiotherapy field. Two-thirds of cases present with extensive disease and therefore with a poor prognosis. Despite achieving high objective response rates (ORR) to treatment, complete response (CR) rates do not exceed 3% and the vast majority of patients relapse early. Currently, immunotherapy, especially PD-1 axis blockade in combination with platinum-based chemotherapy is the standard of care. Clinical case: 57-year-old patient with stage ES-SCLC who achieved CR after four cycles of chemoimmunotherapy with durvalumab and carboplatin + etoposide, which is maintained after twenty-two months of treatment. Conclusion: A relationship has been found between ORR and survival, but it is unknown whether CR can be a surrogate for overall survival in SCLC in the era of immunotherapy. In this case, the absence of poor prognostic factors such as extra-thoracic metastatic disease probably favored CR. Biomarkers such as PD-L1 and TMB currently do not allow for treatment selection. In transcriptomic studies, the inflamed subtype (SCLC-I) appears to have a greater benefit from immunotherapy, however it requires prospective validation studies.