What are ASCO recommendations for second-line therapy for patients with stage IV squamous cell carcinoma (SCC) and non-squamous cell carcinoma (SCC) non–small cell lung cancer (NSCLC)?

Updated: Jun 05, 2020
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

Recommendations for patients with SCC and non-SCC diseZs and negative or unknown EGFR mutation, ALK gene rearrangement status or ROS1 gene rearrangement status are as follows

  • If first-line therapy did not include an immune checkpoint inhibitor, use single-agent nivolumab, pembrolizumab, or atezolizumab in patients with positive tumor PDL-1 expression (TPS ≥ 1%, 22C3 assay); in patients with negative or unknown tumor PDL-1 expression (TPS <1%) use single-agent nivolumab or atezolizumab
  • If first-line therapy included an immune checkpoint inhibitor, offer standard platinum-based chemotherapy
  • For patients with contraindications to immune checkpoint inhibitor therapy, use docetaxel

  • For patients with non-SCC whose pevious therapy did not include pemetrexed, offer pemetrexed


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