Expert Cancer Panel: Stage IV SCC of lung s/p chemo, RT and IO with widespread disease; PD-L1 40%

Recorded on 6/12/2021
73-year-old, reformed smoker (40 pack years), with history of stage IV squamous cell carcinoma of the lung with malignant pleural effusion status post 4 cycles carboplatin/paclitaxel, palliative thoracic radiation therapy followed by nivolumab monotherapy for 5 cycles, now presenting with widespread progressive disease; PD-L1 40%, other mutations negative
Summary:
After progression of stage IV lung squamous cell carcinoma after carboplatin/paclitaxel and nivolumab, docetaxel with ramucirumab is recommended
Alternative systemic therapy options include gemcitabine monotherapy
Rechallenging with checkpoint inhibitors is not recommended given progression on nivolumab
Clinical trial participation should be offered for appropriate patients
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