Abstract
Squamous cell lung cancer (sqCLC) is an aggressive form of cancer that poses many therapeutic challenges. Patients tend to be older, present at a later stage, and have a high incidence of comorbidities, which can compromise treatment delivery and exacerbate toxicity. In addition, certain agents routinely available for nonsquamous cell histologic subtypes, such as bevacizumab and pemetrexed, are contraindicated or lack efficacy in sqCLC. Therapeutic progress has been much slower for advanced sqCLC, with median survival times of approximately 9 to 11 months in most studies. Herein, we discuss the current therapeutic landscape for patients with sqCLC versus with nonsquamous NSCLC. Current evidence indicates that new targeted treatments, notably monoclonal antibodies such as ramucirumab and necitumumab, and immunotherapies such as nivolumab and pembrolizumab can provide survival prolongation, although the benefits are still relatively modest. These incremental improvements, all realized since 2012, in aggregate, will very likely have a clinically meaningful impact for patients with sqCLC. We also discuss recent genomic studies of sqCLC that have identified potentially actionable molecular targets, as well as the relevant targeted agents in clinical development. Finally, we discuss the magnitude of survival benefit and the risk-to-benefit ratio that would prove clinically meaningful in this underserved patient population with unmet needs.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2066-2081 |
| Number of pages | 16 |
| Journal | Journal of Thoracic Oncology |
| Volume | 11 |
| Issue number | 12 |
| DOIs | |
| State | Published - 2016 |
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Keywords
- Advanced
- Clinically meaningful outcomes
- NSCLC
- Squamous cell lung cancer
- Therapeutic landscape
ASJC Scopus subject areas
- Oncology
- Pulmonary and Respiratory Medicine
Cite this
Incremental Innovation and Progress in Advanced Squamous Cell Lung Cancer : Current Status and Future Impact of Treatment. / Langer, Corey J.; Obasaju, Coleman; Bunn, Paul; Bonomi, Philip; Gandara, David R; Hirsch, Fred R.; Kim, Edward S.; Natale, Ronald B.; Novello, Silvia; Paz-Ares, Luis; Pérol, Maurice; Reck, Martin; Ramalingam, Suresh S.; Reynolds, Craig H.; Socinski, Mark A.; Spigel, David R.; Wakelee, Heather; Mayo, Carlos; Thatcher, Nick.
In: Journal of Thoracic Oncology, Vol. 11, No. 12, 2016, p. 2066-2081.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Incremental Innovation and Progress in Advanced Squamous Cell Lung Cancer
T2 - Current Status and Future Impact of Treatment
AU - Langer, Corey J.
AU - Obasaju, Coleman
AU - Bunn, Paul
AU - Bonomi, Philip
AU - Gandara, David R
AU - Hirsch, Fred R.
AU - Kim, Edward S.
AU - Natale, Ronald B.
AU - Novello, Silvia
AU - Paz-Ares, Luis
AU - Pérol, Maurice
AU - Reck, Martin
AU - Ramalingam, Suresh S.
AU - Reynolds, Craig H.
AU - Socinski, Mark A.
AU - Spigel, David R.
AU - Wakelee, Heather
AU - Mayo, Carlos
AU - Thatcher, Nick
PY - 2016
Y1 - 2016
N2 - Squamous cell lung cancer (sqCLC) is an aggressive form of cancer that poses many therapeutic challenges. Patients tend to be older, present at a later stage, and have a high incidence of comorbidities, which can compromise treatment delivery and exacerbate toxicity. In addition, certain agents routinely available for nonsquamous cell histologic subtypes, such as bevacizumab and pemetrexed, are contraindicated or lack efficacy in sqCLC. Therapeutic progress has been much slower for advanced sqCLC, with median survival times of approximately 9 to 11 months in most studies. Herein, we discuss the current therapeutic landscape for patients with sqCLC versus with nonsquamous NSCLC. Current evidence indicates that new targeted treatments, notably monoclonal antibodies such as ramucirumab and necitumumab, and immunotherapies such as nivolumab and pembrolizumab can provide survival prolongation, although the benefits are still relatively modest. These incremental improvements, all realized since 2012, in aggregate, will very likely have a clinically meaningful impact for patients with sqCLC. We also discuss recent genomic studies of sqCLC that have identified potentially actionable molecular targets, as well as the relevant targeted agents in clinical development. Finally, we discuss the magnitude of survival benefit and the risk-to-benefit ratio that would prove clinically meaningful in this underserved patient population with unmet needs.
AB - Squamous cell lung cancer (sqCLC) is an aggressive form of cancer that poses many therapeutic challenges. Patients tend to be older, present at a later stage, and have a high incidence of comorbidities, which can compromise treatment delivery and exacerbate toxicity. In addition, certain agents routinely available for nonsquamous cell histologic subtypes, such as bevacizumab and pemetrexed, are contraindicated or lack efficacy in sqCLC. Therapeutic progress has been much slower for advanced sqCLC, with median survival times of approximately 9 to 11 months in most studies. Herein, we discuss the current therapeutic landscape for patients with sqCLC versus with nonsquamous NSCLC. Current evidence indicates that new targeted treatments, notably monoclonal antibodies such as ramucirumab and necitumumab, and immunotherapies such as nivolumab and pembrolizumab can provide survival prolongation, although the benefits are still relatively modest. These incremental improvements, all realized since 2012, in aggregate, will very likely have a clinically meaningful impact for patients with sqCLC. We also discuss recent genomic studies of sqCLC that have identified potentially actionable molecular targets, as well as the relevant targeted agents in clinical development. Finally, we discuss the magnitude of survival benefit and the risk-to-benefit ratio that would prove clinically meaningful in this underserved patient population with unmet needs.
KW - Advanced
KW - Clinically meaningful outcomes
KW - NSCLC
KW - Squamous cell lung cancer
KW - Therapeutic landscape
UR - http://www.scopus.com/inward/record.url?scp=85010748580&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010748580&partnerID=8YFLogxK
U2 - 10.1016/j.jtho.2016.08.138
DO - 10.1016/j.jtho.2016.08.138
M3 - Review article
C2 - 27575423
AN - SCOPUS:85010748580
VL - 11
SP - 2066
EP - 2081
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
SN - 1556-0864
IS - 12
ER -