Advances and Issues in NSCLC - Episode 1
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Corey J. Langer, MD, Mark A. Socinski, MD, Anne S. Tsao, MD, and David Gandara, MD, discuss treatment options for patients with squamous cell carcinoma.
Langer says that there are two basic options for good performance status, older, squamous cell carcinoma patients with no major comorbidities. While neither option (gemcitabine plus platinum chemotherapy or taxane-platinum combination) will produce negative results, neither will produce particularly beneficial results. Langer says the response rate is usually 25%-35% and progression-free survival (PFS) is rarely better than 4-6 months.
Langer emphasizes that squamous cell carcinoma is particularly difficult to treat because pemtrexed and bevacizumab are not options, maintenance therapy is not effective, and molecular markers are not applicable.
Mark A. Socinski, MD, says that nab-paclitaxel (Abraxane) combined with carboplatin significantly improved overall response rate, when compared with solvent-based paclitaxel plus carboplatin. Socinski notes that nab-paclitaxel did not show statistically significant PFS or overall survival benefit but was approved by the FDA for its response rate.
Anne S. Tsao, MD, says that there is a small window of opportunity for maintenance therapy in patients with squamous cell carcinoma so she emphasizes this in her practice.
Langer disagrees with Tsao, saying that squamous cell patients never seem to make it to maintenance therapy.
David Gandara, MD, concludes the conversation by reiterating that squamous cell carcinoma is an area of unmet need. .