Guo Xiaokang, Wang Jingjing, Li Daosheng, Wang Bin, Zhu Hui, Guo Hongbo
Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Department of Pathology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Front Immunol. 2024 Nov 26;15:1467755. doi: 10.3389/fimmu.2024.1467755. eCollection 2024.
Pulmonary sarcomatoid carcinoma (PSC) is a highly aggressive malignancy with a significant risk of recurrence even after surgical intervention, leading to a dismal prognosis. In recent years, perioperative immunotherapy has demonstrated promising results in resectable non-small cell lung cancer (NSCLC). However, there is a lack of studies reporting the efficacy of perioperative immunotherapy in PSC.
We report the clinical outcomes of four patients diagnosed with locally advanced PSC who underwent neoadjuvant immunotherapy in combination with chemotherapy from 2021 to 2023 in our hospital. Prior to surgery, these patients received 2 to 4 cycles of neoadjuvant treatment. Post-treatment imaging assessments indicated a partial response (PR) in all cases, and each patient successfully achieved R0 resection. Pathological evaluations demonstrated significant pathological responses: one patient attained Pathological Complete Response (PCR), two patients exhibited Major Pathological Response (MPR), and one patient showed PR. Currently, all four patients remain alive without evidence of tumor progression. Notably, the patient who achieved PCR has maintained a disease-free survival (DFS) exceeding 32 months post-surgery, while their event-free survival (EFS) has surpassed 36 months.
Neoadjuvant immunotherapy in combination with chemotherapy has provided new promise for the treatment of locally advanced PSC with surgical potential. But these findings still need to be verified by further prospective researches.
肺肉瘤样癌（PSC）是一种侵袭性很强的恶性肿瘤，即使经过手术干预，复发风险仍很高，预后较差。近年来，围手术期免疫治疗在可切除的非小细胞肺癌（NSCLC）中显示出有前景的结果。然而，缺乏关于围手术期免疫治疗在PSC中的疗效的研究报告。
我们报告了2021年至2023年在我院接受新辅助免疫治疗联合化疗的4例诊断为局部晚期PSC患者的临床结果。手术前，这些患者接受了2至4个周期的新辅助治疗。治疗后影像学评估显示所有病例均有部分缓解（PR），且每位患者均成功实现R0切除。病理评估显示有显著的病理反应：1例患者达到病理完全缓解（PCR），2例患者表现为主要病理反应（MPR），1例患者为PR。目前，所有4例患者均存活，无肿瘤进展迹象。值得注意的是，达到PCR的患者术后无病生存（DFS）已超过32个月，无事件生存（EFS）已超过36个月。
新辅助免疫治疗联合化疗为有手术潜力的局部晚期PSC的治疗提供了新的希望。但这些发现仍需进一步的前瞻性研究来验证。
