Safety. While the incidence of drug -related adverse events (AEs) in the nivolumab 1 mg kg/ipilimumab 3 mg/kg cohort (79% any grade, 30% grade 3- 4) was higher than in the nivolumab monotherapy group (53% any grade, 13% grade 3- 4), the treatment discontinuation rate for treatment -related AEs was only 11% (nivolumab 1 mg/kg / ipilimumab 3 mg /kg): 5 patients with diarrhea, myasthenia gravis [subsequently developing complications with fatal outcome], pneumonitis, cardiomyopathy, and 1 patient with hypothyroidism, hyperglycemia, and increased ALT levels). The most frequent (≥10%, any grade) dr ug-related AEs were diarrhea, fatigue, rash, pruritus, hypothyroidism, rash maculo- papular, nausea, hyperthyroidism, and increased lipase levels. One treatment -related death in the nivolumab 1 mg/kg / ipilimumab 3 mg/kg cohort occurred. This participant de veloped myasthenia gravis (reported as grade 4) after treatment start and suffered from complications resulting in death. Limbic encephalitis was reported in 3 participants, which resolved with immunosuppressive treatment in 2 cases. Another participant had a minor response to immunosuppressive treatment and eventually died due to the underlying tumor disease. Protocol: Version 8.0. September 19, 2018 Page | 21 Efficacy. Patients treated at the recommended phase III dose of ipilimumab 3mg/kg and nivolumab 1mg/kg (n=61) were noted to have an overall response rate (ORR) of 23%, and the disease control rate (CR + PR + SD) was 44%. Objective responses were long lasting, with a median duration of response of 7.7 months in the nivolumab 1mg/ipilimumab 3 mg combination group. The median PFS was 2.6 months (95% CI: 1.4, 4.1) The median OS was 7.7 months (95% CI: 3.6, 18) in the nivolumab 1 mg /ipilimumab 3 mg combination group, which compares favorably with historical controls 81. There is an ongoing phase III randomized, placebo -controlled study (CA209- 451) evaluating PFS and OS among patients with ED -SCLC with at least stable disease after 4 cycles of EP chemotherapy. More than 800 patients are to be randomized to placebo, nivolumab 240 mg delivered every 2 weeks, or ipilimumab 3 mg + nivolumab 1 mg combination therapy for 4 cycles followed by nivolumab 240 mg every 2 weeks until progression. Patients will be carefully monitored on this protocol, and we expect results from our study with comparable inclusion criteria to be available in the coming years. 4.6.3 Rationale for the Use of I pi-Nivo in Combination with Ad.p53- DC The efforts in cancer immune therapy are focused on increasing the frequency of CTL - mediated tumor destruction by applying cancer vaccines, adoptively transferred antigen - specific T cells, inhibitors of check -point blockade (CTLA4, PD -1) or other immune therapeutics 82. However, even in tumor -bearing mice, once tumors are established these interventions have relatively limited efficacy, and the rate of clinical responses in cancer patients, although encouraging, remains relatively low83,84. Ad.p53- DC has demonstrated to be safe and to produce specific cytotoxic immune responses in patients with SCLC. However, the impact on clinical outcomes is still insufficient and strategies that further impr ove the vaccine driven immunotherapy results are necessary. Depletion of MDSC with ATRA, substantially improved the immune response to Ad.p53- DC vaccination supporting an approach of immunotherapy combinations to enhance the effect of immune mediated anti-cancer interventions. Nivolumab monotherapy and nivolumab plus ipilimumab showed antitumour activity with durable responses and manageable safety profiles in previously treated patients with SCLC . In the phase I/II trial (CA209- 032), in participants with heavily pretreated SCLC, nivolumab monotherapy showed an ORR of 10%, whereas the combination of nivolumab- 1 and ipilimumab -3 demonstrated an ORR of 30% 80. Thus, combining these 3, individually safe, partially effective and potentially synergistic strategies into one single strategy is a reasonable approach that deserves clinical testing. Here we propose a phase II trial where ES -SCLC patients with recurrent disease (previously treated with first line chemotherapy) will receive Ad.p53 -DC in combination with ipilimumab and nivolumab to assess the impact of this combination immunotherapy regimen on clinical outcomes . We hypothesize that this combination immunotherapy strategy will improve overall disease response or control and/or survival in this population. Protocol: Version 8.0. September 19, 2018 Page | 22 5.0 METHODOLOGY 5.1 Entry Criteria 5.1.1 Diagnosis/Condition for Entry into the Trial 1) Histologic or cytologic diagnosis of SCLC 2) Recurrence to at least one prior treatment with a platinum containing regimen (cisplatin or carboplatin) including limited stage (LS) and ES initial presentations . NOTE: In patients with SCLC the most frequent platinum containing doublet used is etoposide-carboplatin. However, etoposide-cisplatin and irinotecan or topotecan combined with either carboplatin or cisplatin are platinum doublet regimens that can sometimes be used and thus would be allowed for the purposes of trial enrollment and eligibility. 3) Excluded are patients who upon relapse may be still considered for a salvage concurrent chemo -radiation approach 5.1.2 Subject Inclusion Criteria In order to be eligible for participation in this trial, the subject must: 1. Be wil ling and able to provide written informed consent/assent for the trial.