Expert Review

Relapsed Small Cell Lung Cancer:
Understanding the Biology and Treatment Challenges

CPC Release: 27-12-2022

Valid for credit through: 29-12-2023

Duration 0.75 hour

Patients with small cell lung cancer (SCLC) usually present with extensive-stage (ES) disease and, thus, have a poor prognosis. In this Expert Review, leading experts in the field discuss the current standard of care for ES SCLC, as well as examining the biology of SCLC and molecular subtypes, and assessing the promises and challenges of personalized therapy in ES SCLC. An accompanying slide set summarizes the key data and treatment recommendations for the optimal management of patients with ES SCLC.

This program is available with subtitles in the following languages:


Natasha B. Leighl, MD, MMSc, FRCPC

Natasha B. Leighl, MD, MMSc, FRCPC

Princess Margaret Cancer Centre

Toronto, ON, Canada

Natasha Leighl leads the Thoracic Medical Oncology Group at the Princess Margaret Cancer Centre, and is Professor in the Department of Medicine, and Adjunct Professor in the Institute of Health Policy, Management and Evaluation at the University of Toronto. Dr Leighl holds the OSI Pharmaceuticals Foundation Chair in Cancer New Drug Development through the Princess Margaret Cancer Foundation. She has published over 350 peer-reviewed papers, has held (as principal or co-investigator) over $800 million in peer-reviewed grant funding. She has mentored many trainees that have gone on to leadership roles in oncology around the world and received the American Society of Clinical Oncology Excellence in Teaching Award in 2019.  

Dr. Leighl’s main interest is in developing new treatments in lung cancer and improving lung cancer diagnostics including liquid biopsy. She is involved in clinical studies of novel agents for the treatment of thoracic cancers, has led several international and cooperative group studies in lung cancer, and has served as a member of the Lung Disease Site Group Executive of the Canadian Cancer Clinical Trials Group (CCTG). Dr Leighl was Co-Chair of the CCTG Committee on Economic Analysis, Congress Co-President of the 2018 World Conference in Lung Cancer, and serves on multiple committees including the ASCO Thoracic Guidelines Advisory Group. She is also co-section editor of The Oncologist and Current Oncology, an editorial board member of the Journal of Thoracic Oncology, British Journal of Cancer, a member of the IASLC Quality and Value Committee, on the Scientific Advisory Board of the Lung Cancer Foundation of America, and was recently elected to the Board of Directors of the Americas Health Foundation. Previously, Dr. Leighl has served as Web Editor of the Journal of Thoracic Oncology, on the editorial board of the Journal of Clinical Oncology, on the Royal College of Physicians & Surgeons of Canada Medical Oncology Examination Board, and she is Past-President of Lung Cancer Canada.

Federico Cappuzzo, MD, PhD

Federico Cappuzzo, MD, PhD

IRCCS Regina Elena National Cancer Institute

Rome, Italy

Federico Cappuzzo is the Director of Medical Oncology at the National Cancer Institute Regina Elena, Rome, Italy. In 1992, he graduated in Medicine and Surgery from the Palermo University, and in 1996, he received his degree in Medical Oncology at Milan University, followed by European Society for Medical Oncology (ESMO) certification in Medical Oncology in 1997. From 1997 to 1999, he was the recipient of an ESMO Fellowship on Gene Therapy of Lung Cancer at Institut Gustave Roussy in Villejuif, Paris. In 2000, he attended the Thoracic Oncology Unit at the Medical University of South Carolina, Charleston, USA. He was Assistant Professor at Ospedale Bellaria in Bologna for 6 years and then Assistant Professor in Medical Oncology at Istituto Clinico Humanitas IRCCS in Rozzano (Milano) for 4 years, followed by a position as Visiting Professor in Medical Oncology at University of Colorado in Denver, USA. From 2010 to 2016, Dr. Cappuzzo was the Director of the Medical Oncology Department at the Istituto Toscano Tumori-Ospedale Civile in Livorno. During 2016–2020, he was Director of the Oncology and Hematology Department at AUSL Romagna in Ravenna.

Dr. Cappuzzo is a member of the Italian Association in Medical Oncology (AIOM), ESMO, American Society of Clinical Oncology (ASCO), and International Association for the Study of Lung Cancer (IASCL), and since 2006 he has been a member of the editorial board of Lung Cancer. During 2013–2017, he was the Chairman of the Educational Committee of IASLC. He is the author of more than 250 papers in peer-reviewed journals, mainly in translational research in lung cancer.

Charles Rudin, MD, PhD

Charles Rudin, MD, PhD

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Charles Rudin is the Sylvia Hassenfeld Professor and Chief of Thoracic Oncology at MSKCC, where he also co-directs the Druckenmiller Center for Lung Cancer Research. Dr. Rudin oversees a broad and integrated program of preclinical and clinical research in lung cancer, spanning from basic discovery science, preclinical modeling and novel therapeutic target identification, and first-in-human phase I clinical testing, through leadership of definitive national and international phase III studies. Dr. Rudin has a particular interest in small cell lung cancer (SCLC) and chairs the NCI SCLC Research Consortium, a national network of investigators studying SCLC oncogenesis, mouse and human preclinical modeling, genomic and epigenetic drivers, and therapeutic vulnerabilities.

    • Current standard of care for ES SCLC

    • Closer look at the biology of SCLC and molecular subtypes

    • Personalized therapy in SCLC: Promises, challenges, and future perspectives

This program is specifically designed for medical oncologists, pulmonologists, radiotherapists, and other healthcare professionals involved in the management of patients with SCLC.

Upon completion of this educational activity, participants should be able to:


  • Evaluate available treatment options for patients with ES SCLC in first line and beyond
  • Describe the biological features and genomic alterations in SCLC, and identify SCLC molecular subtypes
  • Explain ongoing strategies for personalized therapy development in SCLC and assess potential predictive biomarkers for response to immunotherapy and targeted therapy

This activity is jointly provided by USF Health and ACE Oncology.


The information provided by this CE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.


USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.


USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CE to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

This educational activity is supported by an independent medical education grant from Merck KGaA, Darmstadt, Germany.






This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and ACE Oncology. USF Health is accredited by the ACCME to provide continuing medical education for physicians.


USF Health designates this enduring material for a maximum of 0.75 hour AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 Credit™ into European CME credit (ECMEC) should contact the UEMS (


Advanced Practice Providers


Physician Assistants may claim a maximum of 0.75 hour Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.


The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 Credit™ by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.


Date of original release: December 30, 2022. Date credit expired: December 29, 2023.

Estimated time to complete activity: 0.75 hour


In order to receive credit for this activity, participants must:


  1. Read the information provided on this page regarding the target audience, learning objectives, and disclosures. Read and study the activity content, complete the post-test questions and the evaluation form.
  2. To claim your AMA PRA Category 1 Credit™ certificate you will be redirected to the USF Health website where you will be able to request the certificate.


If you have questions regarding credit, please contact 

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant financial relationships are listed below. All individuals not listed have no relevant financial relationships.


USF Health Office of Continuing Professional Development and ACE Oncology staff have no relevant financial interests/relationships or affiliations in relation to this activity.




Natasha Leighl, MD, MMSc, FRCPC, FASCO has served as a consultant for Bayer, GlaxoSmithKline, and Puma Biotechnology. They have received grants for clinical research from Amgen, Array BioPharma, Astra Zeneca, Bayer, Bristol Myers Squibb, Eli Lilly, EMD Serono, Guardant Health, Inivata, Janssen, MSD, Novartis, Pfizer, Roche and Takeda. They have received other financial or material support from Amgen, Astra Zeneca, Bristol Myers Squibb, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi and Takeda.


Federico Cappuzzo, MD, PhD has served on the advisory board for Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Galecto, Lilly, Mirati, MSD, Novocure, OSE, Pfizer, Pharmamar, Roche, Sanofi and Takeda. They have served as a consultant for Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Galecto, Lilly, Mirati, MSD, Novocure, OSE, Pfizer, Pharmamar, Roche, Sanofi and Takeda. They have received speaker’s bureau fees from Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Galecto, Lilly, Mirati, MSD, Novocure, OSE, Pfizer, Pharmamar, Roche, Sanofi and Takeda.


Charles Rudin, MD has served on the advisory board for Bridge Medicines, Earli and Harpoon Therapeutics. They have served as a consultant for AbbVie, Amgen, AstraZeneca, Daiichi Sankyo, Epizyme, Genentech/Roche, Ipsen, Jazz, Kowa, Lilly, Merck and Syros (relationships terminated).


Content Reviewer


Robert Coleman, MD has no financial interests/relationships or affiliations in relation to this activity.

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