The treatment of advanced pulmonary sarcomatoid carcinoma

2021 ◽  
Author(s):  
Yue Zheng ◽  
Yang Fu ◽  
Qin Zhong ◽  
Rong Deng ◽  
Yu Zhang
Keyword(s):  
Lung Cancer ◽  
Standard Treatment ◽  
Checkpoint Inhibitors ◽  
Antiangiogenic Therapy ◽  
Sarcomatoid Carcinoma ◽  
Gene Mutations ◽  
Driver Gene ◽  
Pathological Subtype ◽  
Aggressive Cancer ◽  
Pulmonary Sarcomatoid Carcinoma

Pulmonary sarcomatoid carcinoma (PSC) is a pathological subtype of non-small cell lung cancer. Although the incidence of PSC in lung cancer is very low, it is an aggressive cancer, leading to a poor prognosis. Currently, there is no standard treatment for advanced PSC. Targeted therapy can be used for patients with MET exon 14 mutations and patients with other driver gene mutations may also benefit from treatment. The emergence of immune checkpoint inhibitors also provides potential options for advanced PSC treatment, but more clinical data is needed. Additionally, more research may be warranted to explore the effects of chemotherapy, radiotherapy and antiangiogenic therapy. In this review, the authors summarize the research regarding the treatment of advanced PSC.

scholarly journals Case Report: Abscopal Effect of Microwave Ablation in a Patient With Advanced Squamous NSCLC and Resistance to Immunotherapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Chuchu Shao ◽  
Menghang Yang ◽  
Yingying Pan ◽  
Dacheng Xie ◽  
Bin Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Microwave Ablation ◽  
Checkpoint Inhibitors ◽  
Acquired Resistance ◽  
Gene Mutations ◽  
Initial Response ◽  
Driver Gene ◽  
Abscopal Effect ◽  
Squamous Lung Cancer ◽  
Nsclc Patients

Currently, immunotherapy has been a backbone in the treatment of advanced non-small cell lung cancer (NSCLC) without driver gene mutations. However, only a small proportion of NSCLC patients respond to immune checkpoint inhibitors, and majority of patients with initial response will develop acquired resistance at 5 years, which usually manifests as oligo-progression or oligo-metastases. Evidence from multiple clinical trials indicates that local consolidative therapies could improve the prognosis of oligometastatic NSCLC patients. Herein, we reported a case of advanced squamous lung cancer which showed a durable abscopal effect from microwave ablation after acquired resistance of immunotherapy.

Comparison of molecular signatures in small cell lung cancer with or without homologous recombination associated gene mutations.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e20580-e20580
Author(s):  
Lili Fu ◽  
Feifei Li ◽  
Dandan Ren ◽  
Beibei Mao ◽  
Huan Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Homologous Recombination ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Gene Mutations ◽  
Small Cell ◽  
Small Cell Lung ◽  
Homologous Recombination Deficiency

e20580 Background: Small cell lung cancer (SCLC) is an aggressive neuroendocrine subtype of lung cancer with high mortality. Recently, Immune checkpoint inhibitors (ICIs) have been shown to have the potential to improve the prognosis of SCLC, but little is known about immunotherapeutic biomarkers. Homologous recombination deficiency (HRD) is demonstrated to be a response predictor to immunotherapies in gynecologic cancers, while limited studies were reported in small cell lung cancer. Herein, we analyze the mutational pattern of HRR related genes in a Chinese SCLC cohort and further analyze the relationship between HRR-gene mutations and tumor mutational burden. Methods: Target gene sequencing (543 genes) was performed in 133 Genecast cohort with small cell lung cancer. PD-L1 expression were evaluated for 90 among 133 patients using the SP142 PD-L1 immunohistochemistry assay. Results: Among 133 patients, 47 (35.3%) had HRR-gene mutations. ATM (8.3%), NBN (4.5%) and BRCA2 (4.5%) were the top 3 mutated HRR-gene in the cohort，followed by ATR (3.8%), BARD1 (3.8%), BRCA1 (3.8%), PALB2 (3.8%), RAD50 (3.8%), CHEK2 (3.0%), BLM (3.0%), BRIP1(2.3%), CHEK1(1.5%), RAD52(1.5%), and MRE11A (0.8%). Pathogenic somatic and germline mutations of HRR genes were identified in 11 (11/47, 23.4%) and 3 (3/47, 6.4%) patients, respectively. 1 (1/47, 2.1%) patient carried both germline and somatic variants. Genomic landscape revealed that TP53 and RB1 were commonly mutated genes in SCLC cohort. Mutations in KMT2D, AR and RTK-RAS pathway occurred more frequently in the HRR-Mut group, compared with the wildtype ones. Furthermore, we found that mutations in HRR-gene were associated with high TMB (Wilcoxon, p = 0.048), and patients with high TMB (≥median) showed a higher proportion of positive PD-L1 expression in 90 SCLC patients. Conclusions: Our data indicated that genomic alterations associated with HRR-genes have a positive correlation with high TMB, and detection of HRR-gene mutation status probably could help identify patients who might benefit from immune checkpoint blockade therapy. Keywords: Small cell lung cancer, Homologous recombination deficiency, Immunotherapy.

Frequent Mutations of POT1 Distinguish Pulmonary Sarcomatoid Carcinoma From Other Lung Cancer Histologies

2020 ◽  
Vol 21 (6) ◽  
pp. e523-e527 ◽  
Author(s):  
Erica Shen ◽  
Joanne Xiu ◽  
Rex Bentley ◽  
Giselle Y. López ◽  
Kyle M. Walsh
Keyword(s):  
Lung Cancer ◽  
Sarcomatoid Carcinoma ◽  
Frequent Mutations ◽  
Pulmonary Sarcomatoid Carcinoma

scholarly journals Analysis of NTRK mutation and clinicopathologic factors in lung cancer patients in northeast China

2020 ◽  
Vol 35 (3) ◽  
pp. 36-40
Author(s):  
Hui Li ◽  
Shi Yan ◽  
Ying Liu ◽  
Lixia Ma ◽  
Xianhong Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Whole Blood ◽  
Copy Number ◽  
Northeast China ◽  
Fusion Gene ◽  
Gene Mutations ◽  
Driver Gene ◽  
Blood Samples ◽  
Clinicopathologic Factors ◽  
Whole Blood Samples

Objective: NTRK mutations and clinicopathological factors in patients with lung cancer in northeast China were analyzed by next-generation sequencing (NGS), and references were provided for patients with NTRK mutations undergoing targeted therapy in northeast China. Methods: A total of 224 specimens in 173 patients with lung cancer were collected. This included 51 patients with matched tissue and whole blood samples,133 tissue samples, 84 whole blood samples, and 7 pleural effusion samples. NGS (520 genes) was used to detected NTRK mutations and clinicopathologic factors. Results: NTRK mutation was detected in eight patients (8/173, 4.6%), including four NTRK missense mutations (4/173, 2.3%), two NTRK fusion gene mutations (2/173, 1.2%), and two NTRK copy number deletions (2/173, 1.2%). Among the eight patients with NTRK mutations, four were associated with lung cancer driver gene mutations (3/4 EGFR, 1/4ALK); NTRK in two patients was inconsistent in tissue and paired whole blood testing; NTRK missense mutation was detected in one patient, and NTRK copy number deletion was detected in the other; and NTRK wild type was detected in two patients. There was no correlation between NTRK mutation and clinicopathologic factors (including gender, age, pathological type, smoking status, metastasis site). Conclusion: NTRK mutation was only 4.6%, effective fusion gene mutation was 1.2%, and common driver gene mutation in lung cancer was evident in 50% of patients. The results of NTRK were inconsistent with matched tissues and whole blood. Therefore, patients with NTRK mutation should use a variety of specimen types and large target area sequencing (panel) analysis method to provide individualized treatment.

Pulmonary sarcomatoid carcinoma - The experience of a lung cancer unit

2016 ◽  
Author(s):  
Daniela Patríciada Cunha Machado ◽  
Sérgio Campainha ◽  
Sara Conde ◽  
Agostinho Sanches ◽  
Ana Barroso
Keyword(s):  
Lung Cancer ◽  
Sarcomatoid Carcinoma ◽  
Pulmonary Sarcomatoid Carcinoma

Responses to immune checkpoint therapy in pulmonary sarcomatoid carcinoma: A retrospective review.

2019 ◽  
Vol 37 (8_suppl) ◽  
pp. 115-115 ◽  
Author(s):  
Vineeth Sukrithan ◽  
Jason Sandler ◽  
Rasim A. Gucalp ◽  
Richard J. Gralla ◽  
Balazs Halmos
Keyword(s):  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Sarcomatoid Carcinoma ◽  
Stage Iv ◽  
Poor Response ◽  
Complete Response ◽  
Routine Care ◽  
Infectious Complications ◽  
Response To Chemotherapy ◽  
Pulmonary Sarcomatoid Carcinoma

115 Background: Advanced Pulmonary Sarcomatoid Carcinoma (PSC) is associated with poor response to chemotherapy and a median survival of 4-6 months. PSC have a high frequency of PD-L1 positivity and high tumor mutational burden, which are markers of benefit with immune checkpoint inhibitors (ICPI). The parameters of response and survival for PSC treated in the era of immune checkpoint inhibition are unknown. Methods: A review of all cases of advanced PSC diagnosed at two institutions in Bronx, NY between 6/2015-6/2018 was performed. Responses were assessed by serial imaging obtained during routine care and graded by RECIST criteria v 1.1. Results: Five cases of advanced Stage IV PSC are reported. The median age was 57 years and all had received ICPI. All cases were smokers with a median of 30 pack-years and TPS > 75%. Three patients received Pembrolizumab as front-line therapy. Responses were seen in four out of five patients, including one complete response. The fifth patient had prolonged disease stability. After a median follow-up of 13 months, none of the patients had progressed. One patient died of infectious complications after 23 months with no evidence of progression. Four patients continue to be alive with ongoing OS ranging between 14-33 months. Conclusions: ICPI therapy has robust activity in advanced PSC and offers an effective line of therapy in this treatment-refractory aggressive malignancy. [Table: see text]

ALK fusion and its association with other driver gene mutations in Finnish non-small cell lung cancer patients

2014 ◽  
Vol 53 (11) ◽  
pp. 895-901 ◽  
Author(s):  
Katja Tuononen ◽  
Mia Kero ◽  
Satu Mäki-Nevala ◽  
Virinder Kaur Sarhadi ◽  
Milja Tikkanen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Gene Mutations ◽  
Small Cell ◽  
Driver Gene ◽  
Small Cell Lung ◽  
Lung Cancer Patients

scholarly journals A Rare Subtype of Non-small Cell Lung Cancer: Report of 159 Resected Stage I-IIIA Pulmonary Lymphoepithelioma-like Carcinoma Cases

2021 ◽  
Author(s):  
Rong-Rong Jiang ◽  
Xiao-Meng Dou ◽  
Xiao-Li Feng ◽  
Wen-Ting Zhu ◽  
Man-Xia Guo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Squamous Cell ◽  
Cell Lineage ◽  
Gene Mutations ◽  
Small Cell ◽  
Stage I ◽  
Driver Gene ◽  
Small Cell Lung ◽  
Resected Stage

Abstract Background The current study analyzed resected stage I-IIIA pulmonary lymphoepithelioma-like carcinoma (LELC) cases to define the clinical characteristics, prognosis and long-term outcomes of LELC, with the purpose of guiding clinical management for this rare tumor.Methods Resected stage I-IIIA LELC, adenocarcinoma (ADC), squamous cell carcinoma (SCC) and adenosquamous carcinoma (ASC) cases from our center were enrolled. Propensity score matching (PSM) was applied to minimize the selection bias. Overall survival (OS) and disease-free survival (DFS) were compared between groups. Multivariate analyses were performed to identify the prognostic factors, and a nomogram was developed.Results A total of 159 LELCs, 2,757 ADCs, 1,331 SCCs and 155 ASCs were included. LELC, dominated among younger patients and nonsmokers, always presented without typical imaging manifestations of lung cancer. LELC was a poorly differentiated disease that lacked driver gene mutations and was positive for immunohistochemistry indicators of squamous cell lineage. Survival analyses revealed that OS was significantly better for LELC than for other common non-small cell lung cancer (NSCLC) both before PSM (all P < 0.001) and after PSM (all P < 0.05). Further analyses revealed that early pathological node stage and preoperative albumin level ≥35 were identified as independent prognostic factors favoring OS and DFS.Conclusions LELC, dominated among younger and nonsmoking populations, showed a lower extent of malignancy regarding CT characteristics. It lacked driver gene mutations and was positive for immunohistochemistry indicators of squamous cell lineage. The survival outcome of PSC was better than other common NSCLCs.

Sign in / Sign up

Export Citation Format

Share Document