The treatment of Extensive-Stage SCLC was revolutionized by the CASPIAN and IMpower133 trials. Adding a PD-L1 inhibitor to platinum/etoposide is now the global standard of care, providing the first overall survival benefit seen in this disease in decades.

For Limited-Stage patients with a good response to therapy, PCI remains a standard consideration to reduce CNS relapse. In Extensive-Stage disease, MRI surveillance is increasingly used as an alternative to PCI in the immunotherapy era.