Squamous cell lung cancer (SqCLC) is a distinct histologic subtype of NSCLC that is challenging to treat because of specific clinicopathologic characteristics, which include older age, advanced disease at diagnosis, comorbid diseases, and the central location of tumors. These characteristics have a bearing on treatment outcomes in advanced SqCLC, resulting in a median survival approximately 30% shorter than for patients with other NSCLC subtypes. In the context of the specific features of SqCLC, we review challenges of treating SqCLC and the current guideline-recommended treatments for advanced (metastatic) SqCLC in different patient subpopulations. We also evaluate recently approved treatment options, including necitumumab, afatinib, nivolumab, pembrolizumab, and atezolizumab; discuss the survival benefits associated with each agent in the advanced SqCLC population; and propose a treatment algorithm incorporating these agents for this challenging-to-treat disease. Lastly, we review the preliminary clinical evidence for immunotherapy agents in development for advanced NSCLC.

中文翻译：

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晚期鳞状细胞肺癌的当前和紧急治疗选择

鳞状细胞肺癌 (SqCLC) 是 NSCLC 的一种独特的组织学亚型，由于特定的临床病理特征，包括高龄、诊断时的晚期疾病、合并症和肿瘤的中心位置，因此治疗具有挑战性。这些特征对晚期 SqCLC 的治疗结果有影响，导致中位生存期比其他 NSCLC 亚型患者短约 30%。在 SqCLC 的特定特征的背景下，我们回顾了治疗 SqCLC 的挑战以及当前指南推荐的不同患者亚群中晚期（转移性）SqCLC 的治疗方法。我们还评估了最近批准的治疗方案，包括 necitumumab、afatinib、nivolumab、pembrolizumab 和 atezolizumab；讨论与晚期 SqCLC 人群中每种药物相关的生存获益；并针对这种难以治疗的疾病提出了一种包含这些药物的治疗算法。最后，我们回顾了正在开发的晚期 NSCLC 免疫治疗药物的初步临床证据。