skip to main content

ES-SCLC Maintenance — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMedical OncologyES-SCLC MaintenanceRACP Adult Medicine

A 68-year-old man with extensive-stage small cell lung cancer achieves a good response to first-line carboplatin/etoposide plus atezolizumab. He has completed 4 cycles of chemotherapy. What is the recommended maintenance therapy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Atezolizumab maintenance until progression or unacceptable toxicity

For extensive-stage SCLC, the IMpower133 trial (atezolizumab + chemoimmunotherapy) and CASPIAN trial (durvalumab) demonstrated that adding a PD-L1 inhibitor to platinum/etoposide, followed by IO maintenance, improves overall survival. After 4 cycles of induction chemoimmunotherapy, the immune checkpoint inhibitor (atezolizumab or durvalumab) is continued as maintenance monotherapy until disease progression or intolerable toxicity. This is now standard of care and PBS-listed in Australia.

Reference: Cancer Council Australia – 2021 – Lung Cancer OCP; PBS – 2025 – Atezolizumab/Durvalumab SCLC Listing