Emerging Strategies After Immunotherapy in Advanced Squamous NSCLC

In this OncLive Peer Exchange, Dr. Jacob Sands, Dr. Narjust Florez, Dr. Christian Rolfo, and Dr. Edward Kim discuss the evolving treatment landscape for patients with advanced squamous non-small cell lung cancer (NSCLC) whose disease progresses following frontline immunotherapy and platinum-based chemotherapy. The panel reviews the current role of docetaxel, with or without ramucirumab, and examines why treatment advances in squamous NSCLC have historically lagged behind those in nonsquamous disease. The discussion explores emerging approaches under investigation in the post-immunotherapy setting, including antibody-drug conjugates, bispecific therapies, novel immunomodulatory strategies, and next-generation CTLA-4-directed agents. Particular attention is given to the mechanistic rationale, efficacy findings, safety considerations, and interpretation of early clinical data for newer CTLA-4 approaches, including gotistobart. The panel also discusses patient selection, genomic testing, treatment sequencing, chemotherapy-free strategies, toxicity monitoring, community management, clinical trial referral, and anticipated developments in advanced squamous NSCLC.