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During the last 30 years the developments in small cell lung cancer (SCLC) have been extremely scarce. Concurrent chemo-radiation associated with prophylactic cranial irradiation in case of complete clinical remission is standard in limited disease. In extensive disease, platinum/etoposide and topotecan remain the standard systemic approaches in the first- and second-line setting, respectively. The only notable improvement was communicated in the IMpower133 trial, by the addition of atezolizumab to the platinum/etoposide chemotherapy backbone. Against this background, the current article aims to review the most important abstracts presented at ASCO 2019 along with their potential impact for current clinical practice.