The preferred initial treatment for metastatic squamous non-small-cell lung cancer (NSCLC), regardless of PD-L1 status, is Keytruda (Merck & Co.), with a platinum doublet (e.g., carboplatin + Abraxane). As a single agent, Keytruda is given to patients whose tumors have PD-L1 expression levels of 50% or more, who have good performance status, and who are negative for EGFR mutations and ALK rearrangements. Although the rate of EGFR mutations is very low in this patient population (less than 4%), anti-EGFR treatments, such as Gilotrif (Boehringer Ingelheim), are used as subsequent therapy. Because pure squamous NSCLC histology is rarely positive for ALK or ROS1 rearrangements and EGFR or BRAF mutations, metastatic squamous NSCLC patients have fewer treatment options compared with their nonsquamous counterparts. Thus, more treatment options are needed for this NSCLC subpopulation, particularly more-effective and more-tolerable immune checkpoint inhibitor combinations.


  • What are the treatment drivers and goals for metastatic squamous NSCLC?
  • How do current therapies, such as immune checkpoint inhibitors, perform on key treatment drivers and goals for metastatic squamous NSCLC?
  • What are the prevailing areas of unmet need and opportunity in this space?
  • What trade-offs across different clinical attributes and price are acceptable to surveyed oncologists for a hypothetical new first- or later-line treatment for metastatic squamous NSCLC?


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 30 European medical oncologists fielded in June 2020.

Key companies: Merck & Co., Bristol Myers Squibb, Roche / Genentech, Celgene, Eli Lilly, Boehringer Ingelheim.

Key drugs: Keytruda, Opdivo, Opdivo + Yervoy, Tecentriq, Abraxane, Cyramza, Gilotrif / Giotrif.

Table of contents

  • Non-Small-Cell Lung Cancer - Unmet Need - Detailed, Expanded Analysis - Metastatic Squamous NSCLC (US/EU)

Author(s): Pragati Tripathi

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