18F-FDG PET/CT imaging in pulmonary sarcomatoid carcinoma and correlation with clinical and genetic findings

Wu, Xiaodong; Huang, Yan; Li, Yuan; Wang, Qiang; Wang, Huoqiang; Jiang, Lei

doi:10.1007/s12149-019-01374-5

Cited by 21 publications

(49 citation statements)

References 28 publications

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“…KRAS Surprisingly, the rate of KRAS mutation is higher in pure PSC, occurring at a rate of 56% among 49 cases of PSC. 25 and were identified only in smokers, KRAS transversion mutations account for 79%. 3 Chen et al stated that KRAS mutations would reduce the efficacy of chemotherapy drugs and oral targeted drugs in NSCLC.…”

Section: Genetic Characteristicsmentioning

confidence: 99%

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: Genetic Characteristicsmentioning

confidence: 99%

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Liu

et al. 2020

Ther Adv Med Oncol

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“…In PSCs, several reports have investigated the expression of PD1 and/or PD-L1 to envisage a possible use of these therapies in this setting. 101,[123][124][125][126][127][128][129][130][131][132][133] Although widely employed and approved from different national drug agencies, 123 PD-L1 expression is an imperfect predictive biomarker for immunotherapy in lung cancer. PSC tends to show high levels of immunohistochemical expression with PD-L1, even if it is quite difficult to compare the data so far reported in literature in this histology.…”

Section: Psc and Immunotherapymentioning

confidence: 99%

<p>Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma</p>

Baldovini¹,

Rossi²,

Ciarrocchi³

2019

LCTT

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Pulmonary sarcomatoid carcinoma (PSC) is a heterogeneous category of primary lung cancer accounting from 0.3% to 3% of all primary lung malignancies. According to the most recent 2015 World Health Organization (WHO) classification, PSC includes several different variants of malignant epithelial tumors (carcinomas) histologically mimicking sarcomas showing or entirely lacking a conventional component of non-small cell lung cancer (NSCLC). Thus, this rare subheading of lung neoplasms includes pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, pulmonary blastoma, and carcinosarcoma. A diagnosis of PSC may be suspected on small biopsy or cytology, but commonly requires a surgical resection to reach a conclusive definition. The majority of patients with PSC consists of elderly, smoking men with a large, peripheral mass characterized by well-defined margins. However, presentation with a central, polypoid endobronchial lesion is well-documented, particularly in pleomorphic carcinoma and carcinosarcoma showing a squamous cell carcinoma component. As expected, PSC may pose diagnostic problems and immunohistochemistry is largely used when pathologists deal these tumors in routine practice. Indeed, PSC tends to overexpress molecules associated with the epithelial-to-mesenchymal transition, such as vimentin, but the panel of immunostains also includes epithelial markers (cytokeratins, EMA), TTF-1, p40 and negative markers (e.g., melanocytic, mesothelial and sarcoma-related primary antibodies). Although rare, PSC has increased their interest among oncologist community for different reasons: a. identification of the epithelial-to-mesenchymal phenomenon as a major mechanism of secondary resistance to tyrosine kinase inhibitors; b. over-expression of PD-L1 and effective treatment with immunotherapy; c. identification of c-MET exon 14 skipping mutation representing an effective target to crizotinib and other specific inhibitors. In this review, the feasibility of the diagnosis of PSC, its differential diagnosis and novel molecular findings characterizing this group of lung tumor are discussed.

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“…After injection, all patients rested for 1 h and were additionally administered at least 500 mL of water. Imaging was carried out at six or seven bed positions from the base of the skull to the midthighs [15]. Visual analysis and PET/CT measurements were independently performed by two experienced nuclear medicine physicians (W. HQ and L.Q.)…”

Section: F-fdg Pet/ct Acquisition and Analysismentioning

confidence: 99%

“…Recent studies have reported the predictive value of 18 Ffluorodeoxyglucose positron emission tomography/ computed tomography ( 18 F-FDG PET/CT) to determine the PD-L1 expression status in cancer patients; however, their results are not consistent [9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Hence, tumor FDG uptake is generally higher in PD-L1-positive malignancies [9-15, 19, 22].…”

Section: Introductionmentioning

confidence: 99%

Relationship between SP142 PD-L1 Expression and ¹⁸F-FDG Uptake in Non-Small-Cell Lung Cancer

Zhao

Liu

Shi

et al. 2020

Contrast Media & Molecular Imaging

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Objectives. Immune checkpoint blockers constitute the first-line treatment for advanced non-small-cell lung cancer (NSCLC) with ≥50% PD-L1 expression. In NSCLC, PD-L1 positivity is correlated with high 18F-fluorodeoxyglucose (18F-FDG) uptake. However, these studies only included patients undergoing surgical resection, almost all in their early stages. Moreover, differences in 18F-FDG uptake between NSCLC with high (≥50%) and low (49%) PD-L1 expression remain unknown. We aimed to investigate the association between metabolic parameter 18F-FDG uptake and PD-L1 expression status in NSCLC patients. Methods. From February 2017 to June 2018, 428 consecutive NSCLC patients who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) and SP142 PD-L1 expression analysis were retrospectively assessed. The association between clinicopathological characteristics and PD-L1 expression was examined. Results. The frequency of PD-L1-positive tumors was 38.1% (163/428), 28.5% (91/319), and 64.2% (61/95) for NSCLC, adenocarcinoma (ADC), and squamous cell carcinoma (SCC), respectively. Maximal standard uptake (SUVmax) was significantly higher in PD-L1-positive than in PD-L1-negative NSCLC (p<0.0001), ADC (p<0.0001), and SCC (p=0.006). SUVmax was significantly higher in NSCLC (p=0.001) and ADC (p=0.003) with high rather than low PD-L1 expression. The receiver operating characteristic curve yielded area under the curve values of 0.726 (95% CI, 0.679–0.774, p<0.0001), 0.694 (95% CI, 0.634–0.755, p<0.0001), and 0.625 (95% CI, 0.513–0.738, p=0.044) for NSCLC, ADC, and SCC, respectively. Conclusion. 18F-FDG tumor uptake is strongly, positively correlated with PD-L1 expression in NSCLC and significantly differs between high and low PD-L1-expressing individuals.

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18F-FDG PET/CT imaging in pulmonary sarcomatoid carcinoma and correlation with clinical and genetic findings

Cited by 21 publications

References 28 publications

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

<p>Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma</p>

Relationship between SP142 PD-L1 Expression and ¹⁸F-FDG Uptake in Non-Small-Cell Lung Cancer

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18F-FDG PET/CT imaging in pulmonary sarcomatoid carcinoma and correlation with clinical and genetic findings

Cited by 21 publications

References 28 publications

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

<p>Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma</p>

Relationship between SP142 PD-L1 Expression and 18F-FDG Uptake in Non-Small-Cell Lung Cancer

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Relationship between SP142 PD-L1 Expression and ¹⁸F-FDG Uptake in Non-Small-Cell Lung Cancer