Long-term survivor with advanced small-cell lung carcinoma: the role of maintenance immunotherapy and local treatment of oligoprogression

Introduction: Extensive-stage small-cell lung cancer is usually associated with a poor prognosis and a high rate of early relapse, despite its marked initial sensitivity to systemic therapy. Case presentation: We report the case of a 54-year-old former smoker diagnosed with extensive-stage small-cell lung cancer after presenting with superior vena cava syndrome. First-line treatment with carboplatin-etoposide plus atezolizumab achieved a significant radiological response, followed by consolidative thoracic radiotherapy and maintenance atezolizumab. During follow-up, the patient developed a solitary brain metastasis, which was treated with surgical resection and hippocampal-sparing whole-brain radiotherapy, while maintenance immunotherapy was continued. Discussion and Conclusion: This case highlights the potential value of a multimodal approach in selected patients with extensive-stage small-cell lung cancer, combining maintenance immunotherapy with local treatment of oligoprogression to prolong disease control and improve long-term survival.