Efficacy of Immune Checkpoint Inhibitors in Lung Sarcomatoid Carcinoma

Domblides, Charlotte; Leroy, Karen; Monnet, I.; Mazières, Julien; Barlési, Fabrice; Gounant, V.; Baldacci, S.; Mennecier, B.; Toffart, Anne‐Claire; Audigier-Valette, Clarisse; Doucet, Ludovic; Leprieur, Étienne Giroux; Guisier, Florian; Ricordel, Charles; Molinier, Olivier; Pérol, Maurice; Pichon, Éric; Robinet, G.; Templement-Grangerat, D.; Ruppert, Anne-Marie; Rabbe, Nathalie; Antoine, Martine; Wislez, Marie

doi:10.1016/j.jtho.2020.01.014

Cited by 93 publications

(108 citation statements)

References 17 publications

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“…7,45,52 There also have case report of KRAS/TP53/ STK11 co-mutations. 61 It's worth noting that the combination of KRAS and either TP53 or KRAS mutations independently correlated with OS in multivariable models. Both the degree of mutation in KRAS and the presence of TP53 or KRAS mutations are associated with recurrence, especially in the context of local metastasis at relapse.…”

Section: Pd-1/pd-l1mentioning

confidence: 99%

“…The median TMB was 18 mutations/megabase (MMb), accounting for 87.5% of cases with high TMB. 61 However, some reports also documented disease progression with targeted therapy, although the expression lever of PD-L1 >50% and the use of pembrolizumab can stabilize disease. 76 Yang et al believe that PD-L1 expression does not affect clinicopathologic characteristics (univariate analysis), nor does it affect prognoses.…”

Section: Treatmentsmentioning

confidence: 99%

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Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Liu

et al. 2020

Ther Adv Med Oncol

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Pulmonary sarcomatoid carcinoma (PSC) is a unique, highly invasive pulmonary malignancy with a poor prognosis, representing 0.1–0.4% of all malignant lung tumors. Because of its highly aggressive character and propensity for frequent metastasis, PSC shows low response rates to traditional treatments such as chemotherapy, radiotherapy, and neoadjuvant therapy. In recent years, considerable progress has been made in gene sequencing, targeted therapies, and immunotherapies. One of the most promising treatment approaches is the selection of mono-targeted or multi-targeted drugs according to tumor gene-mutation sites, such as epidermal growth factor receptor or vascular endothelial growth factor receptor 2 ( EGFR/VEGFR2), anaplastic lymphoma kinase ( ALK), and others. Another approach is the activation of therapeutic anti-tumor immunity via pathways including programmed cell-death protein-1/programmed cell-death ligand-1 ( PD-1/PD-L1), which has been used in individual cases. In this review, we will introduce the clinicopathologic features, molecular typing, and traditional treatments. We will also review the biological characteristics and the latest therapies for PSC. These novel therapies show promise in the management of PSC, and the outcomes of investigative trials will hopefully reveal a variety of treatment options for patients with PSC.

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Section: Pd-1/pd-l1mentioning

confidence: 99%

Section: Treatmentsmentioning

confidence: 99%

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Liu

et al. 2020

Ther Adv Med Oncol

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“…For example, while chemotherapy is considered in clinical practice, whether chemotherapy can be applied for GSC and the efficacy of chemotherapy remain controversial ( 1 ). Domblides et al first evaluated the efficacy of immune checkpoint inhibitors (ICIs) for SC and found that lung SC patients exhibited high response rates and prolonged overall survival (OS) with ICIs ( 21 ). This study provides a new idea for the treatment of GSC.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Features and Clinicopathological Characteristics of Gastric Sarcomatoid Carcinoma

et al. 2020

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Purpose: Gastric sarcomatoid carcinoma (GSC) is a very rare malignant tumor. The purpose of this study is to describe the clinical, computed tomography (CT), and pathologic features of GSC to increase awareness of this entity. Methods: The CT features and clinical data of five patients with pathologically documented GSC were retrospectively analyzed and compared with the corresponding data of gastric adenocarcinoma and lymphoma. Results: Among the 5 patients, 4 were male, and 1 was female. The median age was 59 years. Of the 5 cases of GSC, 3 were in the gastric fundus and cardia, 1 was in the gastric body, and 1 was in the gastric fundus. The gastric wall had local thickening in 4 cases and mass formation in 1 case, with stenosis and deformation of the adjacent gastric cavity. The long-axis diameter of the lesions ranged from 1.4 to 10.2 cm (mean, 4.97 cm) and was <10 cm in 4 cases and >10 cm in 1 case. The tumor showed predominantly inhomogeneous density, with radiodensity values ranging from 30 to 53 HU. In addition, ulcers with an irregular base and slightly raised borders were observed in 4 of 5 cases. After an injection of contrast material, heterogeneous (n = 4) or homogeneous (n = 1) enhancement was observed. After contrast medium injection, obvious enhancement was seen in 2 cases, and moderate enhancement was seen in 3 cases; the peak tumor signal was observed in the portal phase. Two of the patients demonstrated evidence of lymph node involvement, and in one patient, the boundary between the lesion and the left lobe of the liver was unclear, with low attenuation in the right lobe of the liver with circular enhancement. The remaining two patients showed no evidence of metastasis. Conclusion: Although GSC is extremely rare, it should be considered in the differential diagnosis of gastric adenocarcinoma and lymphoma. CT findings, combined with patient age and sex, can provide support for the diagnosis of GSC. However, the final diagnosis must be confirmed with histopathology.

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“…At present, an army of clinical prediction models are showing a hot trend, but most of the clinical prediction models are general studies of NSCLC, and do not involve the prognosis prediction of GCLC [27][28][29].In order to express this screening and integration data more concretely, we constructed this nomogram for clinical practice conveniently, which predicted its 1 and 3 year survival probability. Contemporarily, with the sustainable basic study and the development of cure strategies [30,31], and the novel detection techniques appeared [32],The new prediction model we have established opens up a novel way for the prognosis prediction of GCLC patients through the independent prognostic factors screened. The evaluation of this model has a well accuracy and calibration.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation a Nomogram and Prognosis of Chemotherapy for Evaluation in Giant-cell Lung Carcinoma With Metastases: A Propensity Score Matching Analysis

Yang¹,

Chen²,

Zhang³

et al. 2020

Preprint

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Background and Objectives: Whether chemotherapy couldimprove prognosis for giant-celllung carcinoma with metastases remains controversial. The present study aimed to determine the significanceof chemotherapy in patients with metastases giant-cell Lung carcinoma, and to develop a nomogram to predict its outcomes.Methods:Data of 566 patients from the Surveillance, Epidemiology, and End Results(SEER) database were analyzed; 346 matched patients were divided into a chemotherapy group and non-chemotherapy group, respectively, using the propensity scorematching method. Univariate and multivariate analyses were performed to determine theprognostic factors of giant-celllung carcinoma, and subgroup analysis was performed according tothe site of metastases. While a visual nomogram wasestablished to judge the prognosis.Results: With the median follow-up of 20.5 months, The 3-yearsurvival rates were 20.2% in the chemotherapy set and 16.7% in the non-chemotherapy set (P=0.006).Chemotherapy did improve the Giant-cell Lung Carcinoma survival rates in patients with metastases(HR = 0.490, 95% CI = 0.358–0.669, P<0.001). In subgroup analysis, radiotherapy did not improved the Giant-cell Lung Carcinoma survival rates in patients with metastases(HR = 0.951, 95% CI = 0.690-1.311, P = 0.758, Table 2). Chemotherapy improved the CSS in patients with lung metastases (HR = 0.090, 95% CI = 0.017-0.470, P =0.004).In addition, chemotherapy improved the CSS in patients with brain metastases (HR = 0.117, 95% CI = 0.014-0.955, P =0.045). Compared with bone metastasis, liver metastasis and metastasis of more than 2 sites, the effect of chemotherapy is not obvious.Furthermore, our nomogram could predict the probability of surviving to the median survival time of the population with a c-index of 0.768.Conclusion:The benefit of chemotherapy in giant-celllung carcinoma with metastases patients was obviously different, andthe recommendation of chemotherapy for this population should be individualized. chemotherapy shouldbe considered for patients with only lungmetastasis or brain metastasis, but chemotherapy could be avoided in those with other site metastases or multiple metastases.We developed the first competing risk nomogram to predict the risk of GCLC patients, which performed well in the evaluation and might be helpful for individualized screening.

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Efficacy of Immune Checkpoint Inhibitors in Lung Sarcomatoid Carcinoma

Cited by 93 publications

References 17 publications

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Computed Tomography Features and Clinicopathological Characteristics of Gastric Sarcomatoid Carcinoma

Development and Validation a Nomogram and Prognosis of Chemotherapy for Evaluation in Giant-cell Lung Carcinoma With Metastases: A Propensity Score Matching Analysis

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