Many studies in small cell carcinoma of the lung (SCCL) have demonstrated a high response rate and a potential for cure in a subset of patients. Combination chemotherapy, the cornerstone of all treatment for SCCL, can produce up to 10% long-term, disease-free survival among all patients with SCCL and greater than or equal to 20% survival among patients who present with limited disease. Significant improvements in survival have occurred in all stages of disease, and further investigative efforts are necessary to improve the complete remission rate, the duration of response, and the percentage of long-term, disease-free survivors. The current report, based on the workshop on SCCL held in Ireland under the auspices of the International Association for the Study of Lung Cancer, reviews the current state of the art for chemotherapy and presents potential future directions.