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Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Targeted therapies for locally advanced or metastatic squamous cell carcinoma of the lung
1University of North Carolina, 170 Manning Drive, POB 3rd Floor, Chapel Hill, NC, 27599-7305, USA, Thomas_stinchcombe@med.unc.edu.
Opinion Statement:
Most patients with squamous cell carcinoma (SCC) present with advanced or metastatic disease at the time of diagnosis. Given the low prevalence of oncogenic driver mutations in SCC, I do not routinely perform molecular testing. The times that I perform molecular testing in SCC are for patients with SCC and a light or never smoking history, adenosquamous histology, or when the histological diagnosis is not definitive. For patients with a good performance status and adequate organ function, a platinum doublet is the standard therapy, and I generally use carboplatin and gemcitabine or carboplatin and paclitaxel. In the second-line setting for patients who are chemotherapy candidates, I will use docetaxel on a weekly or every three week schedule. Erlotinib is a treatment option in the third-line setting. My preference is for patients to participate in clinical trials because the development of novel therapies for patients with SCC has been slow compared with nonsquamous non-small cell lung cancer. Ongoing investigations into the genomics of SCC will hopefully identify driver mutations or alterations in pathways essential for oncogenesis and tumor growth and will lead to the development of targeted therapies. The complexity of the genomics of SCC will make the development of targeted therapies challenging.
Insights
Molecular testing for squamous cell carcinoma (SCC) is limited due to low mutation prevalence. Standard treatments include platinum doublets, with docetaxel and erlotinib for later lines of therapy.
Area of Science:
- Oncology
- Genomics
- Thoracic Cancers
Background:
- Squamous cell carcinoma (SCC) often presents at advanced or metastatic stages.
- Oncogenic driver mutations are infrequently found in SCC, complicating targeted therapy development.
- Current treatment paradigms for SCC lag behind those for nonsquamous non-small cell lung cancer.
Purpose of the Study:
- To outline current clinical practice for molecular testing and treatment of squamous cell carcinoma.
- To highlight the challenges and future directions in developing targeted therapies for SCC.
- To emphasize the importance of clinical trial participation for SCC patients.
Main Methods:
- Clinical opinion and standard treatment guidelines for SCC.
- Discussion of molecular testing criteria in specific SCC patient subgroups.
- Review of first, second, and third-line chemotherapy options for SCC.
Main Results:
- Molecular testing for SCC is reserved for specific cases, including light/never smokers, adenosquamous histology, or uncertain diagnoses.
- Platinum doublets (carboplatin with gemcitabine or paclitaxel) are standard first-line therapy.
- Docetaxel and erlotinib are utilized in second- and third-line settings, respectively.
Conclusions:
- The genomic landscape of SCC presents challenges for targeted therapy development.
- Further research into SCC genomics is crucial for identifying actionable mutations and novel therapeutic strategies.
- Enrollment in clinical trials is strongly encouraged for patients with SCC to access innovative treatments.
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