Advancements in small cell lung cancer (SCLC) management were spotlighted at IASLC 2025, with novel therapeutic options gaining traction. The first-in-human Phase 1 trial of DLL3-targeting ADC SHR-4849 exhibited promising activity in relapsed SCLC, suggesting a new targeted approach for refractory disease. Additionally, data from the Phase 2 IDeate-Lung01 trial revealed high response rates for ifinatamab deruxtecan in pretreated extensive-stage SCLC, reinforcing the potential of ADCs in this domain. Concurrently, a Phase III clinical trial confirmed that a three-week hypofractionated radiotherapy regimen combined with chemotherapy matched the efficacy of conventional protocols for limited-stage SCLC, while reducing toxicity. These developments emphasize the expanding arsenal of effective therapies and optimized radiation strategies for SCLC, a historically challenging malignancy with poor prognosis.