The clinical experience of Italian co-operative groups started in the early 1980s with the first randomised studies on alternating non-cross resistant combination chemotherapy carried out by the Italian Oncology Group for Clinical Research (G.O.I.R.C.) and by the Umbria Lung Cancer Study Group. Later, most of the investigators moved their interest to exploring the clinical relevance of increased dose intensity in the treatment of small cell lung cancer (SCLC). Several trials have been completed and published from Padova, Perugia, Genova and the Oncology Co-operative Group South Italy (G.O.C.S.I.). At the same time, another issue which arose in clinical research of SCLC was the late intensification of treatment after induction chemotherapy. Two ongoing phase II trials were designed at the Milan National Cancer Institute and at the Department of Medical Oncology, in Perugia and Rome. Finally, G.O.C.S.I. and a large Italian co-operative group are evaluating the integration of different modalities of treatment, mainly exploring the role of surgery in the management of limited SCLC.