{"entity":{"id":"chemo-io-then-maintenance-sclc","kind":"pairing","name":"Chemo-immunotherapy induction → maintenance intensification (SCLC)","aka":[],"tldr":"Chemo-immunotherapy followed by maintenance in small-cell lung cancer gives four cycles of chemotherapy plus immunotherapy, then keeps the immunotherapy going and adds a second drug to hold the disease longer.","summary":"This sequence pairing in extensive-stage small-cell lung cancer follows four cycles of platinum plus etoposide with immunotherapy by a maintenance phase in which atezolizumab continues and lurbinectedin is added. The rationale is that the disease almost always relapses soon after induction, so attacking residual disease during the response window with a non-cross-resistant agent should delay relapse. The phase 3 IMforte trial showed that adding lurbinectedin to atezolizumab maintenance improved overall survival, leading to FDA approval in 2025, and DeLLphi-305 is testing tarlatamab in the same maintenance slot. Maintenance intensification is the first new first-line strategy in this cancer since chemo-immunotherapy itself.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT05091567: IMforte","url":"https://clinicaltrials.gov/study/NCT05091567"},{"label":"ClinicalTrials.gov NCT06211036: DeLLphi-305","url":"https://clinicaltrials.gov/study/NCT06211036"}],"tags":[],"related":[],"cancers":["sclc"],"sections":[],"technologies":[],"targets":[],"drugs":["lurbinectedin","atezolizumab","tarlatamab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["imforte","dellphi-305"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"platinum-etoposide","b":"lurbinectedin","rationale":"Extensive-stage SCLC almost always relapses within months of induction; targeting residual disease during the response window with a non-cross-resistant agent delays relapse.","evidence":"Phase 3 IMforte positive (2025, FDA approved); DeLLphi-305 pending.","pairingType":"sequence"},"route":"/pairings/chemo-io-then-maintenance-sclc/","neighbours":{"cancer":[{"id":"extensive-stage-sclc","kind":"cancer","name":"Extensive-stage small-cell lung cancer","route":"/cancers/extensive-stage-sclc/"},{"id":"sclc","kind":"cancer","name":"Small-cell lung cancer","route":"/cancers/sclc/"}],"drug":[{"id":"atezolizumab","kind":"drug","name":"Atezolizumab","route":"/drugs/atezolizumab/"},{"id":"lurbinectedin","kind":"drug","name":"Lurbinectedin","route":"/drugs/lurbinectedin/"},{"id":"platinum-etoposide","kind":"drug","name":"Platinum + etoposide (EP / CE)","route":"/drugs/platinum-etoposide/"},{"id":"tarlatamab","kind":"drug","name":"Tarlatamab","route":"/drugs/tarlatamab/"}],"trial":[{"id":"dellphi-305","kind":"trial","name":"DeLLphi-305","route":"/trials/dellphi-305/"},{"id":"imforte","kind":"trial","name":"IMforte","route":"/trials/imforte/"}]}}