Approximately 3% of cases in one large cohort of SCLC patients had KEAP1 alterations; silencing of this gene has been shown to confer chemoresistance in vitro through deregulation of the nuclear factor erythroid 2-related factor 2 (NRF2) and neurogenic locus notch homolog protein 1 (NOTCH) pathways, making this an attractive target for further studies[77]. This evidence concerns the gene KEAP1 and small cell lung carcinoma.