Treatment Considerations for Patients With Advanced Squamous Cell Carcinoma of the Lung
Source : https://www.clinical-lung-cancer.com/article/S1525-7304(22)00146-2/fulltext
Squamous cell carcinoma (SCC) of the lung has a markedly different molecular profile to adenocarcinoma of the lung and remains difficult to treat because of the lack of targeted therapies for this type of non-small cell lung cancer (NSCLC). With immune checkpoint inhibitors moving from second-line treatment to first-line in NSCLC, effective second-line options following immunotherapy is an urgent unmet need.
Relevance: Squamous cell carcinoma (SCC) of the lung has a markedly different molecular profile to adenocarcinoma of the lung and remains difficult to treat because of the lack of targeted therapies for this type of non-small cell lung cancer (NSCLC). With immune checkpoint inhibitors moving from second-line treatment to first-line in NSCLC, effective second-line options following immunotherapy is an urgent unmet need. Appropriate treatment decisions are currently hindered by a lack of prospective clinical data. However, available real-world data suggest that ramucirumab plus docetaxel warrants prospective evaluation in this setting.
• Source: Lung Cancer
• Conclusion: “In order to ensure patients with SCC [squamous cell carcinoma] of the lung receive optimal treatment, genomic testing is essential to identify those patients who might benefit from existing targeted agents or clinical trials, and further prospective data are urgently required to assess potential second-line regimens following immunotherapy.”
• Adenocarcinoma has outpaced SCC in the identification and targeting of driver mutations. Nevertheless, various first-line immunotherapies are available for the disease including the immune-checkpoint inhibitors nivolumab, pembrolizumab and atezolizumab.
• NCCN Guidelines advise individuals with metastatic SCC NSCLC receive testing for ALK, EGFR, ROS1, KRAS, B-RAF, NTRK1/2/3, MET exon 14 skipping, and RET genomic alterations, in addition to PD-L1 expression
• “While rapid advances in first-line immunotherapy have revolutionized treatment of SCC of the lung,” the authors wrote, “these advances have generated a void in terms of potential second-line treatment options. Prospective data are urgently required to assess potential second-line regimens following immunochemotherapy. While they do not substitute for prospective trials, recent real-world observational studies support the consideration of ramucirumab plus docetaxel, or afatinib, in this setting.”