Advancing therapeutics in small-cell lung cancer.

Small-cell lung cancer (SCLC) accounts for 10-15% of lung cancers and is characterized by early metastasis, treatment resistance and rapid progression. Treatment advancements have been stagnant for decades, with chemotherapy as the mainstay and immune checkpoint inhibitors offering only modest survival extensions. However, new insights into tumor heterogeneity and recent practice-changing observations such as the identification of targetable cell surface proteins could effectively transform SCLC therapy. In this Review, we highlight key advances in SCLC biology, therapeutic innovation and biomarker development. Finally, we discuss the role of reverse translation in optimizing treatments, approaches to overcoming resistance and ensuring equitable access to care.