Skip to main content

Immunotherapy for Small Cell Lung Cancer

Immunotherapy is the use of medicines to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively.

Immune checkpoint inhibitors

An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses “checkpoints” or proteins on immune cells that need to be turned on (or off) to start an immune response. Cancer cells sometimes use checkpoints to avoid being attacked by the immune system. Drugs that target these checkpoints can be used to treat some people with small cell lung cancer (SCLC).

  • Atezolizumab (Tecentriq) and durvalumab (Imfinzi) target PD-L1, a protein related to PD-1 that is found on some tumor cells and immune cells. Blocking this protein can also help boost the immune response against cancer cells. These drugs can be used as part of the first treatment for advanced SCLC, along with etoposide and a platinum chemo drug (like carboplatin or cisplatin). Either drug can then be continued alone as maintenance therapy. This combination of PD-L1 immunotherapy with chemotherapy also seems to help some people with SCLC live longer.

These drugs are given as an intravenous (IV) infusion, typically every 2, 3, or 4 weeks.

Possible side effects of immunotherapy for SCLC

Side effects of these drugs can include fatigue, cough, nausea, skin rash, decreased appetite, constipation, joint pain, and diarrhea.

Other, more serious side effects occur less often.

Infusion reactions: Some people might have an infusion reaction while getting these drugs. This is like an allergic reaction, and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. It’s important to tell your doctor or nurse right away if you have any of these symptoms while getting these drugs.

Autoimmune reactions: These drugs remove one of the safeguards on the body's immune system. Sometimes the immune system responds by attacking other parts of the body, which can cause serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, or other organs.

It’s very important to report any new side effects to someone on your cancer care team as soon as possible. If serious side effects do occur, treatment may need to be stopped and you might be given high doses of corticosteroids to suppress your immune system.

More information about immunotherapy

To learn more about how drugs that work on the immune system are used to treat cancer, see Cancer Immunotherapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Horn L, Mansfield AS, Szczęsna A, Havel L, Krzakowski M, Hochmair MJ et al. First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer. N Engl J Med. 2018 Dec 6;379(23):2220-2229.

National Cancer Institute. Physician Data Query (PDQ). Health Professional Version. Small Cell Lung Cancer Treatment. 2023. Accessed at https://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq on Jan 24, 2024.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer. V.2.2024. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf on Jan 24, 2024.

Ott PA, Elez E, Hiret S, Kim DW, Morosky A, Saraf S et al. Pembrolizumab in Patients With Extensive-Stage Small-Cell Lung Cancer: Results From the Phase Ib KEYNOTE-028 Study. J Clin Oncol. 2017 Dec 1;35(34):3823-3829.

Paz-Ares L, Dvorkin M, Chen Y, Reinmuth N, Hotta K, Trukhin D, et al. Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Lancet. 2019;394(10212):1929-1939. doi: 10.1016/S0140-6736(19)32222-6. Epub 2019 Oct 4.

Petty WJ, Paz-Ares L. Emerging Strategies for the Treatment of Small Cell Lung Cancer: A Review. JAMA Oncol. 2023 Mar 1;9(3):419-429. doi: 10.1001/jamaoncol.2022.5631. PMID: 36520421.

Last Revised: January 29, 2024

American Cancer Society Emails

Sign up to stay up-to-date with news, valuable information, and ways to get involved with the American Cancer Society.