Second-Line Treatment in Squamous NSCLC

In this segment, the panel discusses the current treatment approach for patients with advanced squamous non-small cell lung cancer (NSCLC) whose disease progresses following frontline immunotherapy and platinum-based chemotherapy. Dr. Narjust Florez describes a representative patient scenario and highlights the limited treatment options available after progression, particularly for patients who are reluctant to receive additional chemotherapy. The panel reviews docetaxel, with or without ramucirumab, as the current standard treatment option and discusses findings from the REVEL trial, which established an overall survival benefit for the combination compared with docetaxel alone in the pre-immunotherapy era. The experts also consider how these historical data translate to contemporary patients who have previously received immune checkpoint inhibitors. Factors influencing treatment selection, including performance status, contraindications, prior treatment experience, and patient concerns about chemotherapy, are discussed. The panel concludes by emphasizing the need for additional clinical trial options in advanced squamous NSCLC.