Checkpoint Inhibitors in Squamous Non-Small Cell Lung Cancer (NSCLC)
Journal Title: Open Access Journal of Oncology and Medicine - Year 2018, Vol 2, Issue 3
Abstract
Checkpoint inhibitors have demonstrated efficacy in squamous NSCLC with tolerable toxicity profile. They are used as a monotherapy, in combination with chemotherapy or following chemo-radiotherapy as a first line, second line or consolidation therapy. As a first line, Pembrolizumab improves outcome (PFS) as a monotherapy in patients with PD-L1 expression of ≥ 50% (HR; 0.35). When used with chemotherapy, it improves PFS (HR; 0.56) irrespective of PD-L1 expression level. Nivolumab also improves PFS (HR; 0.62), when used as a second line for those progressing with chemotherapy. Durvalumab improves PFS (HR; 0.68) when used following chemo-radio therapy as a consolidation therapy. Lung cancer remains the most common cancer diagnosis and the leading cause of cancer-related deaths, with approximately 1.8 million new cases and 1.59 million deaths accounting every year worldwide [1]. Non-small cell lung cancer (NSCLC) covers the 80% of these lung cancer cases and mainly includes two large histological subsets, adenocarcinoma and squamous non-small cell lung cancer (Sq NSCLC) Clinically also Sq NSCLC differs remarkably from adenocarcinoma as it is located more centrally, and arise segmentally involving lobar or main bronchi and often having central cavitation. There is difference in molecular markers also. Based on molecular changes targeted therapies have been developed for subtypes of adenocarcinoma of lung e.g. EGFR inhibitors. Their use is associated with improved outcome with better tolerability. However, such advances have not taken place in management of Sq NSCLC and the conventional platinum-based chemotherapy remained the first line and second line option for patients with Sq NSCLC till recently. Necitumab approved for Sq NSCLC did not became popular due to its side effect profile and limited benefit [2]. Introduction and development of checkpoint inhibitors has changed the management of Sq NSCLC. Checkpoint inhibitors have been evaluated in NSCLC in whole spectrum ranging from neoadjuvant to third line settings and has been indicated as first line, second line and consolidation therapy [2,3]. In this review, information related to use of check point inhibitor in the treatment of Sq NSCLC is presented.
Authors and Affiliations
Bakulesh Khamar
Keywords
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- EP ID EP589149
- DOI 10.32474/OAJOM.2018.02.000140
- Views 94
- Downloads 0
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