5
PS 2
➤ In the context of shared decision making, combination therapy, single
agent therapy, or palliative therapy alone may be used for patients
with the characteristics described in Clinical Question A3a:
• Chemotherapy (Weak Recommendation; EB-B-I).
• Palliative care (Strong Recommendation; EB-B-I).
A3. High PD-L1 Status (TPS ≥50%), and PS 0–1
➤ For patients with high PD-L1 expression (TPS ≥ 50%) SCC, PS 0–1,
in the absence of contraindications to immune checkpoint inhibitor
therapy:
• 3.1. Clinicians should offer single-agent pembrolizumab (Strong
Recommendation; H).
• 3.2. Clinicians may offer pembrolizumab/carboplatin/(paclitaxel or nab-
paclitaxel) (Moderate Recommendation; I).
• 3.3. In addition to 2020 options, for patients with high PD-L1 expression (TPS
≥50%), SCC, and PS 0–1, clinicians may offer single-agent atezolizumab (Strong
Recommendation; M).
• 3.4. In addition to 2020 options, for patients with high PD-L1 expression (TPS
≥50%), SCC, and PS 0–1, clinicians may offer single-agent cemiplimab (Strong
Recommendation; M).
• 3.5. In addition to 2020 options, for patients with high PD-L1 expression (TPS
≥50%), SCC, and PS 0–1, clinicians may offer nivolumab and ipilimumab alone
or nivolumab and ipilimumab plus two cycles of platinum-based chemotherapy
(Weak Recommendation; M).
• 3.6. (previously #3.3.) There are insufficient data to recommend any other
checkpoint inhibitors or to recommend combination checkpoint inhibitors
or any other combinations of ICIs with chemotherapy in the first-line setting
(Strong Recommendation; H).
