Abstract
Locally advanced or metastatic non-small cell lung cancer (NDCLC) is an incurable disease. Squamous cell carcinoma (SQC, 30% of all NSCLC) usually does not carry positive driving mutations, which allow the use of biologically targeted treatment; so chemotherapy is the basic treatment for the patients.
Chemotherapy is also the standard treatment for the second line - docetaxel monotherapy. In the third line, also in patients without driving mutations, after the failure of previous chemotherapy erlotinib can be used.
From 1.4.2018, there is a reimbursement in the Czech Republic for an immunotherapy, immune check-point inhibitor of PD-1 (programmed cell death) receptor - preparation nivolumab (Opdivo). Reimbursement is not tied to PD-L1 expression; preparation is also active in PD-L1 negative patients.
Authors present the nivolumab treatment results in 19 patients with SQC, treated in early access program. The median survival in the cohort is 12,5 months.
Six patients (31%) have been surviving to the date of 27. 4. 2018 for more than two years, nearly 2,5 years. Severe adverse events (grade 3-4) were observed in two patients.
This was the colitis and the eye muscles plegia. Second line treatment with nivolumab in SQC patients provides a chance for long-term survival and even for complete curing.