title: Incremental Innovation and Progress in Advanced Squamous Cell Lung Cancer: Current Status and Future Impact of Treatment.
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.
authors: Department of Thoracic Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Corey.langer@uphs.upenn.edu.
authors: Corey J
authors: CJ
authors: Langer
authors: Eli Lilly and Company, Indianapolis, Indiana.
authors: Coleman
authors: C
authors: Obasaju
authors: University of Colorado Cancer Center, Aurora, Colorado.
authors: Paul
authors: P
authors: Bunn
authors: Rush University Medical Center, Chicago, Illinois.
authors: Philip
authors: P
authors: Bonomi
authors: Department of Hematology and Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors: David
authors: D
authors: Gandara
authors: University of Colorado Cancer Center, Aurora, Colorado.
authors: Fred R
authors: FR
authors: Hirsch
authors: Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina.
authors: Edward S
authors: ES
authors: Kim
authors: Cedars-Sinai Comprehensive Cancer Center, West Hollywood, California.
authors: Ronald B
authors: RB
authors: Natale
authors: University of Turin, Turin, Italy.
authors: Silvia
authors: S
authors: Novello
authors: Hospital Universitario Doce de Octubre and Centro Nacional de Investigaciones Oncológicas, Madrid, Spain.
authors: Luis
authors: L
authors: Paz-Ares
authors: Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France.
authors: Maurice
authors: M
authors: Pérol
authors: Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany.
authors: Martin
authors: M
authors: Reck
authors: Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors: Suresh S
authors: SS
authors: Ramalingam
authors: U.S. Oncology Research, Ocala, Florida.
authors: Craig H
authors: CH
authors: Reynolds
authors: Florida Hospital Cancer Institute, Orlando, Florida.
authors: Mark A
authors: MA
authors: Socinski
authors: Sarah Cannon Research Institute, Nashville, Tennessee.
authors: David R
authors: DR
authors: Spigel
authors: Stanford University School of Medicine, Palo Alto, California.
authors: Heather
authors: H
authors: Wakelee
authors: Eli Lilly and Company, Indianapolis, Indiana.
authors: Carlos
authors: C
authors: Mayo
authors: The Christie Hospital, Manchester, United Kingdom.
authors: Nick
authors: N
authors: Thatcher
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*
keywords: Advanced; Clinically meaningful outcomes; NSCLC; Squamous cell lung cancer; Therapeutic landscape