Biological characteristics and clinical treatment of pulmonary sarcomatoid carcinoma: a narrative review

作者全名：Wei, Yuxuan; Wang, Lei; Jin, Zheng; Jia, Qingzhu; Brcic, Luka; Akaba, Tomohiro; Chu, Qian

作者地址：[Wei, Yuxuan; Wang, Lei; Chu, Qian] Huazhong Univ Sci & Technol, Tongji Hosp, Dept Oncol, 1095 Jiefang Ave, Wuhan 430030, Peoples R China; [Jin, Zheng] Chongqing Med Univ, Inst Life Sci, Chongqing, Peoples R China; [Jin, Zheng] GloriousMed Clin Lab Shanghai Co Ltd, Res Inst, Shanghai, Peoples R China; [Jia, Qingzhu] Third Mil Med Univ, Xinqiao Hosp, Inst Canc, Chongqing, Peoples R China; [Jia, Qingzhu] Third Mil Med Univ, Xinqiao Hosp, Chongqing Key Lab Immunotherapy, Chongqing, Peoples R China; [Brcic, Luka] Med Univ Graz, Diagnost & Res Inst Pathol, Graz, Austria; [Akaba, Tomohiro] Tokyo Womens Med Univ, Dept Resp Med, Tokyo, Japan

通信作者：Chu, Q (通讯作者)，Huazhong Univ Sci & Technol, Tongji Hosp, Dept Oncol, 1095 Jiefang Ave, Wuhan 430030, Peoples R China.

来源：TRANSLATIONAL LUNG CANCER RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001223124200017

JCR分区：Q1

影响因子：4

年份：2024

卷号：13

期号：3

开始页：635

结束页：653

文献类型：Review

关键词：Pulmonary sarcomatoid carcinoma (PSC); biology; clinical characteristics; treatment strategies

摘要：Background and Objective: Pulmonary sarcomatoid carcinoma (PSC) is a subset of non -small cell lung cancer (NSCLC) with highly malignant, aggressive, and heterogeneous features. Patients with this disease account for approximately 0.1-0.4% of lung cancer cases. The absence of comprehensive summaries on the basic biology and clinical treatments for PSC means there is limited systematic awareness and understanding of this rare disease. This paper provides an overview of the biological characteristics of PSC and systematically summarizes various treatment strategies available for patients with this disease. Methods: For this narrative review, we have searched literature related to the basic biology and clinical treatment approaches of PSC by searching the PubMed database for articles published from July 16, 1990 to August 29, 2023. The following keywords were used: "pulmonary sarcomatoid carcinoma", "genetic mutations", "immune microenvironment", "hypoxia", "angiogenesis", "overall survival", "surgery", "radiotherapy", "chemotherapy", and "immune checkpoint inhibitors". Key Content and Findings: Classical PSC comprises epithelial and sarcomatoid components, with most studies suggesting a common origin. PSC exhibits a higher tumor mutational burden (TMB) and mutation frequency than other types of NSCLC. The tumor microenvironment (TME) of PSC is characterized by hypoxia, hypermetabolism, elevated programmed cell death protein 1/programmed cell death-ligand 1 expression, and high immune cell infiltration. Treatment strategies for advanced PSC are mainly based on traditional NSCLC treatments, but PSC exhibits resistance to chemotherapy and radiotherapy. The advancement of genome sequencing has introduced targeted therapies as an option for mutation -positive PSC cases. Moreover, due to the characteristics of the immune microenvironment of PSC, many patients positively respond to immunotherapy, demonstrating its potential for the management of PSC. Conclusions: Although several studies have examined and assessed the TME of PSC, these are limited in quantity and quality, presenting challenges for research into the clinical treatment strategies for PSC. With the emergence of new technologies and the advancement of clinical research, for example, savolitinib's clinical study for MET exon 14 skipping mutations positive PSC patients have shown promising outcomes, more in-depth studies on PSC are eagerly anticipated.

基金机构：Key Research and Development Program of Hubei Province [YFXM2022000329]

基金资助正文：Funding: This work was supported by grants from the Key Research and Development Program of Hubei Province (Grant No. YFXM2022000329 to Q.C.) .