Small cell lung cancer is a very special type of lung cancer: “small children” – compared to adenocarcinoma and squamous lung cancer, small cell lung cancer is smaller, but more malignant and has a very short survival time. Patients have an extremely short survival period. Small cell lung cancer accounts for about 15% of all lung cancer patients and is initially very sensitive to radiotherapy and chemotherapy. Since the 1980s, a two-drug chemotherapy regimen containing platinum has been the treatment of choice for advanced small cell lung cancer: the efficiency is about 60%-70%, but most patients relapse within a few months, and the disease is unstoppable. The average overall survival for advanced small cell lung cancer, is less than one year. For more than a decade, targeted therapy for lung cancer, especially lung adenocarcinoma, has been in full swing: for patients with EGFR mutations, consider Eressa, Troche, Kemal sodium, Afatinib, AZD9291; for patients with ALK rearrangement mutations, consider Crizotinib, Ceritinib, Lauratinib, Alectinib, Brigatinib; for lung squamous carcinoma, there are fewer targeted drugs, but at least There is also Necitumumab, a monoclonal antibody targeting EGFR, which has been approved by the US FDA and can extend patient survival by 1.6 months on average. In addition, immunotherapy has been making waves in the treatment of lung cancer in the last five or six years, and even PD-1 antibodies have replaced chemotherapy as the treatment of choice for non-small cell lung cancer with PD-L1 expression above 50%. All of the above, however, seems to have nothing to do with small cells. For more than three decades, small cell lung cancer, no other new chemotherapeutic agent has been marketed, and none of the targeted agents have been marketed. Sensitivity to immunotherapy has not been proven. But there is still hope. Rovalpituzumab tesirine is a new drug that targets a protein known as DLL3, a drug that has brought life to 74 patients with small cell lung cancer who had failed other treatments. Dose: The dose administered was escalated from 0.05 mg/kg to 0-8 mg/kg every 3 weeks or every 6 weeks and finally found: 0.3 mg/kg every 6 weeks was the optimal dosing. Efficacy: Of the 60 patients evaluable for efficacy, 11 patients were effective, with an efficiency rate of 18%, and among those at doses close to the optimal dose, the efficiency rate was 25%, with a disease control rate of 72%. More promisingly, of the 26 patients positive for DLL3, 10 were effective, with an efficiency rate of 38%. The patients who received near-optimal doses of DLL3 were 55% effective, and the disease control rate was 91%. People may say, 55% is not high, like lung cancer, the efficiency of targeted drugs is 70%, 80% or even higher. However, the radish has to say that no new drugs have been available for small cell lung cancer for three decades. Other treatment failure of small cell lung cancer, if you continue to choose radiotherapy, the efficiency may barely reach 5%; two new immune drugs priced at more than 100,000 odd dollars per month, only barely reach 20%; this a single targeted drug, efficiency exceeded 50%, has been very difficult. Side effects: Grade 3-4 serious side effects are mainly: pleural fluid/ ascites, thrombocytopenia and skin reactions. Phase III clinical trials on this new drug for DLL3 positive small cell lung cancer are currently underway, so let’s wait and see. Note: Please refer to the clinic for specific medication and be guided by the doctor’s interview.