In contrast to the impressive improvements that were made in the treatment of patients with non-small cell lung cancer, the treatment for patients with small-cell lung cancer (SCLC) remained largely unchanged during the past three decades. More recently, however, immune checkpoint inhibitors have been gaining momentum in this setting. In Belgium, patients with extensive stage (ES) SCLC now have the choice between two effective treatment regimens combining an immune checkpoint inhibitor with chemotherapy. In addition to this, several other immunotherapy-based therapies are being scrutinised in clinical trials with ES SCLC patients.