page_title: Non-small-cell lung carcinoma
section_title: Other treatment options
hierarchical_section_title: Non-small-cell lung carcinoma / Treatment / Other treatment options
context_page_description: Non-small-cell lung carcinoma is any type of epithelial lung cancer other than small cell lung carcinoma. NSCLC accounts for about 85% of all lung cancers. As a class, NSCLCs are relatively insensitive to chemotherapy, compared to small cell carcinoma. When possible, they are primarily treated by surgical resection with curative intent, although chemotherapy has been used increasingly both pre-operatively and post-operatively.
context_section_description: NSCLC patients with advanced disease who are not found to have either EGFR or ALK mutations may receive bevacizumab which is a monoclonal antibody medication targeted against the vascular endothelial growth factor (VEGF).  This is based on an Eastern Cooperative Oncology Group study which found that adding bevacizumab to carboplatin and paclitaxel chemotherapy for certain patients with recurrent or advanced non-small-cell lung cancer (stage IIIB or IV) may increase both overall survival and progression free survival.
  In 2015 the US FDA approved the anti-PD-1 agent nivolumab for advanced or metastatic squamous cell carcinoma.
  October 2, 2015, the FDA approved pembrolizumab for the treatment of metastatic non-small cell lung cancer (NSCLC) in patients whose tumors express PD-L1 and who have failed treatment with other chemotherapeutic agents.
  October 2016, pembrolizumab became the first immunotherapy to be used first line in the treatment of NSCLC if the cancer overexpresses PDL1 and the cancer has no mutations in EGFR or in ALK; if chemotherapy has already been administered, then pembrolizumab can be used as a second line treatment but if the cancer has EGFR or ALK mutations, agents targeting those mutations should be used first. Assessment of PDL1 must be conducted with a validated and approved companion diagnostic.
caption: Micrograph showing a PD-L1 positive non-small cell lung carcinoma. PD-L1 immunostain.
exif: {}