Dr. Patel on Treatment Considerations in Advanced Squamous NSCLC

Shiven B. Patel, MD, MBA, FACP, an assistant professor of medical oncology, Huntsman Cancer Institute, University of Utah, discusses treatment considerations in patients with advanced squamous non—small cell lung cancer (NSCLC).

Typically, if a patient has a PD-L1 tumor proportion score (TPS) between 1% and 49%, the combination of chemotherapy and immunotherapy is the standard of care. However, older patients may not be fit enough to receive chemotherapy; in that case, immunotherapy alone would be a suitable alternative, says Patel. Chemoimmunotherapy and immunotherapy alone are indicated for use in the frontline setting, so treatment can be tailored as needed, he adds.

Sick patients who have a high burden of disease and a PD-L1 TPS of ≥50% need to quickly respond to therapy. Although the data suggest similar efficacy between immunotherapy alone and chemoimmunotherapy in that population, the response rates are higher with chemoimmunotherapy, says Patel. Therefore, even though these patients have a PD-L1 TPS of ≥50%, chemotherapy would be the optimal way to shrink their tumor and reduce their symptoms, concludes Patel.