Small Cell Lung Cancer (SCLC) is associated with intensive nicotine consumption and characterized by a very aggressive growth rate. Furthermore, metastases often appear very early. At the annual meeting of the "American Society of Clinical Oncology" (ASCO) 2007, recent issues which will influence the daily clinical practice were presented. New chemotherapy combinations such as carboplatin/irinotecan or pemetrexed as well as targeted therapies e.g. bevacizumab in combination with chemotherapy could extend our therapeutic options. A genetic polymorphism, which influences the pharmacokinetic of irinotecan, turned out to be one reason for the different outcome of an irinotecan/cisplatin therapy in a Japanese and Northern American population. In the field of radiotherapy, a phase III study showed for the first time a significant benefit in overall survival by prophylactic cranial radiation in the setting of extensive disease.