Efficacy of first-line immune checkpoint inhibitors in pulmonary sarcomatoid carcinoma.

Background

Pulmonary sarcomatoid carcinomas (PSC) are notorious for their poor prognosis and resistance to chemotherapy. The literature suggests that immunotherapy might be effective against this aggressive tumor. This study aims to evaluate the efficacy of immunotherapy, either alone or combined with chemotherapy, as first-line treatment for PSC patients.

Methods

In a retrospective, multicentric, real-world study conducted between July 2017 and April 2021, patients with stage III (ineligible for surgery or radio-chemotherapy) or stage IV PSC were enrolled. These patients received their first-line treatment with immunotherapy and were categorized into two groups based on their treatment modality: the immuno-chemotherapy (IO CT) group or the immunotherapy-alone (IO) group.

Results

This study analyzed a population of 34 patients from eight different hospital centers. In this cohort, the objective response rate (ORR) was 56%, median duration of response was 20.5 months, median progression-free survival (PFS) was 5.11 months, and median overall survival (OS) 13.9 months. Demographic characteristics remained consistent among the treatment groups except for the age (54.0- and 71.0-year-old in the IO CT and IO group, respectively, P=0.02). The IO CT group demonstrated an ORR of 64.0%, a median PFS at 8.72 months, and a median OS of 16.08 months, while the IO group displayed respective values of 52.0%, 3.45 months, and 13.11 months.

Conclusions

This study showed the potential efficacy of immunotherapy as a first-line treatment for PSC. While acknowledging the retrospective nature of the study, our findings suggest a trend favoring the combination of IO CT over IO alone in these patients.

Informations de copyright

2024 AME Publishing Company. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-24-263/coif). N.G. received research grants/support from Abbvie, Amgen, AstraZeneca, Beigene, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi-Sankyo, Gilead, Hoffmann-La Roche, Janssen, LeoPharma, Lilly, Merck Serono, Merck Sharp & Dohme, Novartis, Sanofi, Sivan; provided consultative services for Abbvie, Amgen, AstraZeneca, Beigene, Bristol Myers Squibb, Daiichi-Sankyo, Gilead, Ipsen, Hoffmann-La Roche, Janssen, LeoPharma, Lilly, Merck Sharp & Dohme, Mirati, Novartis, Pfizer, Pierre Fabre, Sanofi, Takeda; participated on a data safety monitoring board for Hoffmann-La Roche; employment of a family member with AstraZeneca. Jacques Cadranel received consulting fees for participation to boards of experts from AMGEN, AZ, Daiichi (and travelling, BMS, MSD, Roche, Sanofi, Janssen (and travelling), Takeda, Pfizer (and travelling). I.M. received honoraria from Regeneron and support from Takeda, MSD, Pfizer, Oxyvie. E.G.L. received honoraria from AMGEN, AstraZeneca, Ipsen, Janssen, Lilly, MSD, Novartis, Pfizer, Sanofi, Takeda and support for attending meetings and/or travel from Takeda, MSD, AstraZeneca. K.L. received honoraria from AstraZeneca, MSD, Janssen, GSK, Lilly, AMGEN, Roche for lectures, presentations or educational events and support for attending meetings and/or travel from AMGEN. Jeanne Chapron received honoraria from BMS, AstraZeneca, Pfizer, Sanofi, MSD and support for attending meetings and/or travel from Sanofi and Regeneron. M.W. received payment or honoraria for lectures and presentations from AMGEN, AstraZeneca, Bristol Myers Squibb, F. Hoffmann-La Roche, Janssen, MSD Oncology, Lilly, Merck KGaA; grants from AstraZeneca; support for attending meetings and/or travel from Janssen, Amgen, MSD and F. Hoffmann-La Roche; participated on a data safety monitoring board or advisory board for AMGEN, AstraZeneca, Bristol Myers Squibb, F. Hoffmann-La Roche, Janssen, MSD Oncology, Lilly and Merck KGaA. The other authors have no conflicts of interest to declare.