Loading
6 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Squamous cell carcinoma is the second most common type of lung cancer and the one most tightly linked to smoking; it starts in the flat cells lining the large central airways. Unlike adenocarcinoma it rarely carries a mutation a tablet can target, so treatment rests on chemotherapy with immunotherapy, and pemetrexed and bevacizumab are not used.
Squamous cell carcinoma shows keratinisation, intercellular bridges or, when poorly differentiated, expression of p40 or p63 without TTF-1; the WHO classification divides it into keratinising, non-keratinising and basaloid forms (the last has its own page) and in 2021 moved lymphoepithelial carcinoma into the squamous group (Nicholson 2022). Tumours are typically central and cavitate. Genomically it is a disease of complex, smoking-related damage rather than single drivers: the 178 tumours of the Cancer Genome Atlas averaged 360 exonic mutations each, TP53 was mutated in nearly all, NFE2L2 or KEAP1 in 34 percent and the squamous differentiation genes in 44 percent, and loss-of-function mutations in HLA-A were a new finding (TCGA 2012). EGFR mutations and ALK fusions are rare enough that guidelines test only never-smokers or mixed tumours.
How it differs from its parent: the non-small-cell lung cancer page and its driver subpages are largely about adenocarcinoma. In squamous disease the driver pathway rarely applies, pemetrexed is inactive and bevacizumab is avoided because of bleeding from central tumours, so the chemotherapy backbone is platinum with paclitaxel, nab-paclitaxel or gemcitabine.
| Setting | Approach | Guideline |
|---|---|---|
| Metastatic, first line | Carboplatin with paclitaxel or nab-paclitaxel plus pembrolizumab (KEYNOTE-407); cemiplimab with chemotherapy or the parent's PD-L1-high pathway as alternatives. | not mapped |
| Metastatic, later lines | Docetaxel with or without ramucirumab; afatinib; biomarker-matched drugs through Lung-MAP. | not mapped |
| Early stage | Treated as the parent's resectable and stage III pages describe. | not mapped |