Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China.
Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Eur J Cancer. 2024 Sep;209:114260. doi: 10.1016/j.ejca.2024.114260. Epub 2024 Aug 2.
Immune checkpoint inhibitors (ICIs) have improved the prognosis of patients with non-small cell lung cancer but rarely been explored in pulmonary sarcomatoid carcinoma (PSC). This multicenter study aimed to evaluate the effectiveness of ICIs for PSC and its underlying mechanism.
Advanced PSC who received ICIs between August 2018 and May 2022 from 11 centers in China were included. Clinical characteristics and treatment information were collected. Whole-exome sequencing (WES) and whole transcriptome sequencing were conducted on pre-treatment samples to explore the mechanism.
113 patients with PSC were enrolled, the median PFS for patients receiving ICIs therapy was 8.77 months (95 % confidence interval, 4.21 to 13.32). Combining ICIs with anti-angiogenic agents significantly increased PFS (p = 0.04). Liver metastasis and combination therapy with anti-angiogenic agents were independent risk factors for PFS (Hazard Ratio [HR] = 3.652, p = 0.019 and HR = 0.435, p = 0.017, respectively). WES showed that PSC presented with a TMB of 6.3 mutations per million base pairs. High expression of TNFα signaling and glycolysis related gene showed a better prognosis.
ICIs showed promising benefits for advanced PSC, and the addition of anti-angiogenic therapy might be a more effective treatment strategy for this disease.
免疫检查点抑制剂 (ICIs) 改善了非小细胞肺癌患者的预后，但在肺肉瘤样癌 (PSC) 中很少被探索。这项多中心研究旨在评估 ICI 对 PSC 的疗效及其潜在机制。
纳入了 2018 年 8 月至 2022 年 5 月期间来自中国 11 个中心的接受 ICI 治疗的晚期 PSC 患者。收集了临床特征和治疗信息。对治疗前样本进行全外显子测序 (WES) 和全转录组测序，以探索其机制。
共纳入 113 例 PSC 患者，接受 ICI 治疗的患者中位 PFS 为 8.77 个月（95%置信区间，4.21 至 13.32）。ICI 联合抗血管生成药物治疗显著提高了 PFS（p=0.04）。肝转移和联合抗血管生成药物治疗是 PFS 的独立危险因素（HR=3.652，p=0.019 和 HR=0.435，p=0.017）。WES 显示 PSC 的 TMB 为每百万碱基对 6.3 个突变。TNFα 信号和糖酵解相关基因高表达提示预后更好。
ICI 对晚期 PSC 显示出良好的疗效，联合抗血管生成治疗可能是治疗这种疾病更有效的策略。
