a Department of Oncology, Division of Experimental Medicine , IRCCS San Raffaele , Milan , Italy.
b Medical Oncology Department , Institute of Oncology Rosell (IOR), University Hospital Sagrat Cor , Barcelona , Spain.
Expert Rev Respir Med. 2017 Jun;11(6):469-479. doi: 10.1080/17476348.2017.1326822. Epub 2017 May 15.
The treatment of lung cancer has radically changed over the last few years. The discovery of druggable oncogenic alterations and the introduction of immunotherapy have provided lung cancer patients with the possibility of more efficient and less toxic therapeutic alternatives than chemotherapy. In the case of lung squamous cell carcinoma (LSCC), the treatment progress is slower than adenocarcinoma, for which several targeted agents have been already approved. The standard first-line therapy for LSCC, in most sites of the world, is platinum-based chemotherapy. After disease progression, these patients now have novel treatment options, including antiangiogenic agents and immune checkpoint blockade. Areas covered: We provide a summary of the recent novelties for the second-line therapy of LSCC, emphasizing on the results of the most important clinical trials that have led to regulatory approvals. Expert commentary: Immune checkpoint inhibitors have changed the therapeutic algorithm for LSCC patients. Other treatment options in the second-line setting include ramucirumab in combination with docetaxel and afatinib. However, we still lack biomarkers to predict which patients could respond better to each treatment. Despite the identification of several actionable molecular alterations, there are no approved targeted agents specific for advanced LSCC. Results from ongoing biomarker-driven studies are eagerly awaited to establish effective treatments for molecularly selected subgroups of patients.
过去几年中，肺癌的治疗方法发生了根本性的变化。可靶向药物治疗的致癌改变的发现和免疫疗法的引入，为肺癌患者提供了比化疗更有效、毒性更小的治疗选择。在肺鳞状细胞癌（LSCC）的情况下，治疗进展比腺癌缓慢，因为已经批准了几种靶向药物。在世界上大多数地区，LSCC 的标准一线治疗是铂类化疗。在疾病进展后，这些患者现在有新的治疗选择，包括抗血管生成药物和免疫检查点抑制剂。涵盖领域：我们总结了 LSCC 二线治疗的最新进展，重点介绍了导致监管批准的最重要临床试验的结果。专家评论：免疫检查点抑制剂改变了 LSCC 患者的治疗方案。二线治疗的其他选择包括雷莫芦单抗联合多西他赛和阿法替尼。然而，我们仍然缺乏生物标志物来预测哪些患者对每种治疗的反应更好。尽管已经确定了几个可靶向的分子改变，但没有针对晚期 LSCC 的特定靶向药物。正在进行的基于生物标志物的研究结果备受期待，以期为分子选择的患者亚组建立有效的治疗方法。
