Liu SV, Reck M, Mansfield AS, et al. - In patients with extensive-stage small-cell lung cancer (ES-SCLC) who were studied in a randomized, double-blind, phase I/III study (IMpower133), significant improvement in overall survival (OS) and progression-free survival was achieved with the addition of atezolizumab (anti-programmed death-ligand 1 [PD-L1]) to carboplatin plus etoposide (CP/ET) vs placebo plus CP/ET as first-line (1L) treatment, researchers here present updated OS, disease progression patterns, safety, as well as exploratory biomarkers (PD-L1, blood-based tumor mutational burden). Patients were managed with atezolizumab plus CP/ET (n = 201) or placebo plus CP/ET (n = 202). A median OS of 12.3 months was obtained with atezolizumab plus CP/ET while it was 10.3 months with placebo plus CP/ET. In the atezolizumab plus CP/ET and placebo plus CP/ET arms, 34.0% and 21.0% of patients remained alive at 18 months, respectively. In the updated analysis, atezolizumab plus CP/ET continued to offer improved OS as well as a tolerable safety profile as first line treatment for ES-SCLC, supporting this treatment regimen as a new standard of care. Independent of biomarker status, exploratory analyses showed a treatment benefit.