Squamous cell carcinoma of the lung: clinical criteria for treatment strategy

Abstract

Aim: Primary lung cancer is the leading cause of human cancer deaths worldwide, and squamous cell carcinoma (SCC) is one of the most frequent histologic subtypes. The aim of our study was to analyze clinical factors potentially affecting the overall outcome of advanced lung SCC patients.

Methods: A series of 72 consecutive patients with advanced SCC undergoing chemotherapy at our institution between January 2007 and July 2013 were eligible for our analysis.

Results: By univariate analysis, a better overall survival (OS) was related to response to first-line chemotherapy: median OS were 19.7 vs. 7.17 months, respectively, for responders and nonresponders patients (P < 0.0001). Eastern Cooperative Oncology Group performance status, gender, and surgery were other prognostic factors. No significant relationship between OS and smoking status, age, body mass index, or type of treatment was found. In the third-line setting, a better OS was associated with objective response to second-line treatment (P = 0.015).

Conclusion: Our results suggest that differences in OS seem strictly associated with clinical response to previous treatments. These data should be considered in the therapeutic strategy and management of patients with SCC of the lung.

Keywords

Non-small cell lung cancer / prognostic factors / squamous cell carcinoma

References

[1] Travis WD.Pathology of lung cancer..Clin Chest Med2011;32:669-92

[2] Thunnissen E,Herth FJ,Papotti M,Rossi G,Weynand B,Katrien G,López-Ríos F,Olszewski W,Jaume S,Thiberville L.The challenge of NSCLC diagnosis and predictive analysis on small samples. Practical approach of a working group..Lung Cancer2012;76:1-18

[3] Giaccone G.Epidermal growth factor receptor inhibitors in the treatment of non-small-cell lung cancer..J Clin Oncol2005;23:3235-42

[4] Kwak EL,Camidge DR,Solomon B,Ou SH,Jänne PA,Varella-Garcia M,Lynch TJ,Stubbs H,Sequist LV,Gandhi L,Wei GC,Ratain MJ,Christensen JG,Wilner K,Shapiro GI,Iafrate AJ.Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer..N Engl J Med2010;363:1693-703 PMCID:PMC3014291

[5] Rekhtman N,Arcila ME,Oxnard GR,Travis WD,Kris MG.Clarifying the spectrum of driver oncogene mutations in biomarker-veriffied squamous carcinoma of lung: lack of EGFR/KRAS and presence of PIK3CA/AKT1 mutations..Clin Cancer Res2012;18:1167-76 PMCID:PMC3487403

[6] Metro G.Novel molecular trends in the management of advanced non-small-cell lung cancer..Expert Rev Anticancer Ther2012;12:729-32

[7] Riess JW.Metastatic non-small cell lung cancer management: novel targets and recent clinical advances..Clin Adv Hematol Oncol2012;10:226-34

[8] Thatcher N,Szczesna A,Szafranski W,Ramlau R,Bálint B,Kazarnowicz A,Schumann C,Paz-Ares L,Nanda S,Socinski MA.A randomized, multicenter, open-label, phase III study of gemcitabine-cisplatin (GC) chemotherapy plus necitumumab (IMC-11F8/LY3012211) versus GC alone in the first-line treatment of patients (pts) with stage IV squamous non-small cell lung cancer (sq-NSCLC)..J Clin Oncol2014;32:5s

[9] Pirker R.Epidermal growth factor receptor-directed monoclonal antibodies in nonsmall cell lung cancer: an update..Curr Opin Oncol2015;27:87-93

[10] Peters S,Gridelli C,Kerr K.Metastatic non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up..Ann Oncol2012;23:vii56-64

[11] Scagliotti GV,Rapetti S.Current state-of-the-art therapy for advanced squamous cell lung cancer..Am Soc Clin Oncol Educ Book2013;2013:354-8

[12] Aggarwal C.Older age, poor performance status and major comorbidities: how to treat high-risk patients with advanced non small cell lung cancer..Curr Opin Oncol2012;24:130-6

[13] Giroux Leprieur E,Ruppert AM,Wislez M,Milleron B.Factors associated with long-term survival of patients with advanced non-small cell lung cancer..Respirology2012;17:134-42

[14] Leung EY,McMillan DC.Clinical utility of the pretreatment Glasgow prognostic score in patients with advanced inoperable non-small cell lung cancer..J Thorac Oncol2012;7:655-62

[15] Pirker R,Szczesna A,Krzakowski M,Vynnychenko I,Eberhardt WE,Heeger S,O'Byrne KJ.Prognostic factors in patients with advanced non-small cell lung cancer: data from the phase III FLEX study..Lung Cancer2012;77:376-82

[16] Weiss GJ,Fossella F,Stahel R,Nguyen B,McAndrews P,Kelly K.The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer..Ann Oncol2007;18:453-60

[17] Grothey A,Goldberg RM.Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment..J Clin Oncol2004;22:1209-14