For non-small cell lung cancer patients with localized or regional disease, treatment options vary little according to histology. For metastatic NSCLC "targeted" therapies for patients with EGFR activating mutations or ALK translocations, pemetrexed, and the addition of bevacizumab to conventional chemotherapy have improved the treatment of metastatic NSCLC. Unfortunately, all of these improvements apply almost exclusively to NSCLC adenocarcinoma histotype.
For squamous cell carcinoma of the lung (SQC), the standard treatment remains cytotoxic chemotherapy, usually consisting of a platinum-containing doublet (carboplatin>US, cisplatin>Europe) with docetaxel or erlotinib used as second-line agents.
Similar to adenocarcinomas, squamous cell carcinomas are a heterogenous group of clinically, molecularly, and genetically different tumors. Current work on SQCs is focused on identifying unique molecular patterns or driver mutations that may be therapeutic targets. Kathryn Gold, Ignacio Wistuba and Edward Kim have published an excellent review of this recent work on SQC in Clinical Cancer Research 2012 18(11); 3002–7 that I recommend if you want a state-of-the-art update.
This review is more clinically oriented (for the pathologist) but provides connections between observed molecular abnormalities with drugs in various stages of development and current trials. One interesting development is a phase II trial opening soon looking at the agent NCT01514864 for patients with squamous cell carcinoma with a mutation in discoidin domain receptor 2 kinase (DDR2). I previously posted on a paper that identified DDR2 kinase mutations in lung squamous cell carcinoma about a year ago--so this is some exciting stuff! DDR2 kinase mutations occur in about 4% of SQC which doesn't seem like much until you input the denominator of the number of lung SQC diagnosed per year--this is analogous to EML-ALK translocations in lung ADC.
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