Non-Squamous and Squamous NSCLC is the most common type of lung cancer, accounting for around 85% of all lung cancer cases. NSCLC can be categorized into various subtypes based on tumor cell type - the two main subtypes being non-squamous and squamous NSCLC. While treatment approaches and outcomes may differ between these subtypes, advances in immunotherapy and targeted therapies are improving patient outcomes across both.



Immune Checkpoint Inhibitors Gaining Momentum



Immunotherapy has revolutionized cancer treatment in recent years by harnessing the body's own immune system to fight cancer. A key class of immunotherapy drugs known as immune checkpoint inhibitors have shown notable success in NSCLC. Checkpoint inhibitors like pembrolizumab, nivolumab and atezolizumab work by removing brakes on the immune system called checkpoints, allowing immune cells to better recognize and attack cancer cells.



Clinical trials have shown these drugs can achieve response rates of around 20% when used as monotherapy in advanced NSCLC patients whose tumors do not have targetable mutations. Response tends to be more durable than with chemotherapy as well. Key trials like KEYNOTE-024 established pembrolizumab as a new standard first-line option for PD-L1-high expressing tumors without targetable mutations. Ongoing research is evaluating checkpoint inhibitors alone or in combinations across various NSCLC subtypes and treatment settings.



Targeted Therapies Make Progress in Specific Mutations



While immunotherapy has broadened treatment options, targeted therapies continue making progress as well - but for select patient subgroups. Mutations in genes like EGFR, ALK and ROS1 are targets for numerous FDA-approved small molecule kinase inhibitors and antibody drugs in Advanced Non-Squamous and Squamous NSCLC EGFR inhibitors like osimertinib have significantly improved outcomes in advanced mutated EGFR NSCLC compared to chemotherapy.



Ongoing trials are evaluating new targeted combinations and sequencing approaches. For instance, the FLAURA trial showed superior efficacy for osimertinib over older EGFR inhibitors as initial treatment in EGFR-mutated NSCLC. ALK inhibitors too have transitioned treatment from chemotherapy to newer genotypes. Brigatinib gained approval based on superior intracranial efficacy over crizotinib in advanced ALK+ NSCLC in the ALTA trial. However, resistance often develops, driving continued research on targeting downstream pathways and mutations.



Chemotherapy Remains Important Option



While immunotherapy and targeted therapy have made advances, chemotherapy still remains an important treatment option. For many NSCLC patients without targetable mutations or those who progress on other treatments, platinum-based chemotherapy doublets continue serving as standard first-line therapy based on efficacy demonstrated in landmark trials decades ago.



The carboplatin or cisplatin regimen paired with a third-generation agent like paclitaxel, pemetrexed or gemcitabine is frequently utilized. Recent years have seen newer chemotherapy combinations and sequencing evaluated in trials as well. Immuno-chemotherapy combinations are an active area of research to leverage potential synergies between therapies that work via distinct mechanisms. Ongoing studies seek better defining optimal sequencing and combination strategies across mutation statuses and subtypes.



Trials Test Novel Concepts and Multi-Modality Approaches



Research seeks continually addressing resistance challenges and improving outcomes. Trials are testing novel targeted agents against specific mutations emerging as drivers of secondary resistance. Combining immunotherapies or adding them to chemotherapy or targeted therapy backbones is a major focus. Other trial concepts explore predictive biomarkers, mechanisms of resistance and overcoming them through rational agent sequencing or multi-modality strategies.



For instance, studies are assessing if adding immunotherapy earlier during treatment or following disease control on other therapies improves outcomes. Multimodality approaches combining different localized therapies like radiation with systemic treatments also aim improving outcomes. Advances in predictive biomarkers, understanding of tumor immune microenvironment and mechanisms of response or resistance will help personalize treatment choices for NSCLC patients going forward.



In summary, significant progress thanks to research and approval of effective new treatment options like immune checkpoint inhibitors and molecularly targeted therapies is improving outcomes for Advanced Non-Squamous and Squamous NSCLC across clinical settings. However, lung cancer remains a complex disease where resistance develops and not all patients benefit. Ongoing clinical trials and research will be important for continuing innovations to help all patient populations and fully capitalize on the potential of immunotherapy, precision medicines and multi-modality approaches.

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Money Singh is a seasoned content writer with over four years of experience in the market research sector. Her expertise spans various industries, including food and beverages, biotechnology, chemical and materials, defense and aerospace, consumer goods, etc. (https://www.linkedin.com/in/money-singh-590844163)

*Note:

1. Source: Coherent Market Insights, Public sources, Desk research

2. We have leveraged AI tools to mine information and compile it