Dr. Halmos on Second-Line Treatment in Metastatic Squamous NSCLC

Balazs Halmos, MD, MS

Balazs Halmos, MD, MS, director of thoracic oncology and director of clinical cancer genomics, Montefiore Medical Center, discusses second-line treatment for patients with metastatic squamous non–small cell lung cancer (NSCLC).

If a patient progresses on chemoimmunotherapy in the first-line setting, their options are limited in the second-line, explains Halmos. As it stands, the standard of care for the management of metastatic nonsquamous NSCLC, metastatic squamous cell lung cancer, and extensive-stage small cell lung cancer should be a combination of chemotherapy and immunotherapy, says Halmos.

While second-line chemotherapy does benefit patients, benefits that can be enhanced in the right subsets with the addition of ramucirumab (Cyramza), physicians must work harder to achieve more than what second-line chemotherapy can do, says Halmos. Physicians need to understand the mechanisms of resistance to immunotherapy and focus on individualized strategies in terms of chimeric antigen receptor T cells and other classes of agents. There is a lot of research that physicians still need to do, though a lot has been accomplished, Halmos concludes.
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