Dr. Gandara on Treatment Options for Squamous Cell NSCLC

David R. Gandara, MD, director, Thoracic Oncology Program, professor, senior advisor to director, UC Davis Comprehensive Cancer Center, treasurer, International Association for the Study of Lung Cancer (IASLC), a 2017 Giant of Cancer Care^® in Lung Cancer, discusses treatment options for patients with squamous cell non—small cell lung cancer (NSCLC). This has been considered an area of unmet need.

For the last several years, researchers have continued to find targetable oncogenes that are primarily in adenocarcinomas—for example, EGFR, ALK, and ROS1. But, these are rarely found in squamous NSCLC. Luckily, Gandara says, data indicate that this space is eligible for immune checkpoint inhibitors. A lot of this has to do with high levels of tumor mutational burden, which are present in squamous NSCLC and is an effective biomarker for immunotherapy response. There are at least 2 positive trials for frontline immunotherapy and chemotherapy in patients with squamous NSCLC.

In July 2018, the FDA granted a priority review designation to a supplemental biologics license application for frontline pembrolizumab (Keytruda) in combination with carboplatin/paclitaxel or nab-paclitaxel (Abraxane) for the treatment of patients with metastatic squamous NSCLC, regardless of PD-L1 expression.