Phase II study of carboplatin–paclitaxel alone or with bevacizumab in advanced sarcomatoid carcinoma of the lung: HOT1201/NEJ024

Oizumi, Satoshi; Takamura, Kei; Harada, Toshiyuki; Tachihara, Motoko; Morikawa, Naoto; Honda, Ryoichi; Watanabe, Satoshi; Asao, Tetsuji; Kunisaki, Mamoru; Fukuhara, Tatsuro; Noro, Rintaro; Kikuchi, Eiki; Tsutani, Yasuhiro; Tenma, Toshiyuki; Kobayashi, Kunihiko; Dosaka‐Akita, Hirotoshi

doi:10.1007/s10147-021-02113-5

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…A phase II study (UMIN000008707) included 9 patients treated with carboplatin plus paclitaxel alone or combination with bevacizumab. Patients who received combination therapy had an ORR of 44.4% (PR: 4; SD: 3; PD: 2) a median PFS of 4.2 months, and a median OS of 11.2 months, which was significantly superior to those who underwent chemotherapy alone ( 111 ). The feasibility of antiangiogenic therapy combined with chemotherapy is highly apparent.…”

Section: Clinical Characteristics and Treatmentmentioning

confidence: 97%

“…A phase II study investigating carboplatin plus paclitaxel with or without bevacizumab enrolled 16 patients with PSC. Among them, seven patients received carboplatin plus paclitaxel alone, resulting in a 0% ORR (SD: 2; PD: 4; not evaluable: 1), a median PFS of 1.2 months, and a median OS of 7.9 months ( 111 ). In another study, patients treated with platinum-based chemotherapy had a better OS than those treated with non–platinum-based chemotherapy (7.0 vs. 5.3 months; P=0.096) ( 4 ), which was corroborated by another study (5.6 vs. 1 month) ( 2 ).…”

Section: Clinical Characteristics and Treatmentmentioning

confidence: 99%

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

Wei,

Wang,

Jin

et al. 2024

Transl Lung Cancer Res

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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.

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Section: Clinical Characteristics and Treatmentmentioning

confidence: 97%

Section: Clinical Characteristics and Treatmentmentioning

confidence: 99%

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

Wei,

Wang,

Jin

et al. 2024

Transl Lung Cancer Res

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“…It is resistant to treatment with cytotoxic agents, and the overall survival (OS) after initiation of systemic treatment with cytotoxic agents has been estimated to range from 5 to 8 months, on average 2–4 . A phase II trial suggested that combined administration of a vascular endothelial growth factor inhibitor and cytotoxic agent might be effective, but the efficacy is limited, as the median progression‐free survival (PFS) and OS have been estimated to be 4.2 months and 11.2 months, respectively 5 …”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4] A phase II trial suggested that combined administration of a vascular endothelial growth factor inhibitor and cytotoxic agent might be effective, but the efficacy is limited, as the median progression-free survival (PFS) and OS have been estimated to be 4.2 months and 11.2 months, respectively. 5 Recently, immune checkpoint inhibitors (ICIs) have been shown to confer survival benefit in patients with NSCLC. Cytotoxic agents have been used as the standard therapy for NSCLC patients without driver mutations, but the efficacy is limited, with a reported 2-year survival rate of 18.9% in patients treated with cisplatin plus pemetrexed.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of immune checkpoint inhibitor therapy in patients with pulmonary sarcomatoid carcinoma in clinical practice

et al. 2023

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Objective Studies have suggested the potential efficacy of immune checkpoint inhibitors (ICIs) for pulmonary sarcomatoid carcinoma. This multicenter observational study was conducted to evaluate the efficacy of systemic ICI therapy and chemoradiation followed by durvalumab therapy for pulmonary sarcomatoid carcinoma. Methods We analyzed the data of patients with pulmonary sarcomatoid carcinoma who received systemic ICI therapy or chemoradiation followed by durvalumab therapy between 2016 and 2022. Results In this study, data of a total of 22 patients who received systemic ICI therapy and four patients who received chemoradiation followed by durvalumab therapy were analyzed. In the patients who received systemic ICI therapy, the median progression‐free survival after initiation of therapy was 9.6 months, and the overall survival did not reach the median. The 1‐year progression‐free survival rate and overall survival rate were estimated to be 45.5% and 50.1%, respectively. Although the log‐rank test revealed no significant association between the tumor expression level of programmed death ligand‐1 (tumor proportion score evaluated using 22C3 antibody: ≥50% vs. <50%) and the survival duration, the majority of patients showing long‐term survival showed a tumor proportion score of ≥50%. Of four patients treated with chemoradiation followed by durvalumab therapy, two patients showed an overall survival of ≥30 months, whereas the remaining two patients died within 12 months. Conclusion The progression‐free survival of patients who received systemic ICI therapy was 9.6 months, suggesting that ICI therapy might be effective in patients with pulmonary sarcomatoid carcinoma.

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An observational study on the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma

Tsuda,

Ichikawa,

Matsumoto

et al. 2024

Discov Onc

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Background Pulmonary sarcomatoid carcinoma is a rare tumor that is resistant to cytotoxic agents. This observational study aimed to evaluate the detection rate of driver gene alteration and the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma. Methods We established a database of patients with pulmonary sarcomatoid carcinoma and their clinical information, including EGFR mutation, ALK fusion gene, ROS1 fusion gene, BRAF mutation, and MET exon 14 skipping mutation. The present study retrieved and analyzed the data of patients with pulmonary sarcomatoid carcinoma in whom driver gene alterations were evaluated, and the survival duration after the initiation of treatment with targeted therapy was examined. Results A total of 44 patients were included in the present study. The EGFR mutation, ALK fusion gene, and MET exon 14 skipping mutation were detected in 2/43 patients (4.7%), 2/34 patients (5.9%), and 2/16 patients (12.5%), respectively. The ROS1 fusion gene (0/18 patients) and BRAF mutation (0/15 patients) were not detected. Female patients (P = 0.063, Fisher’s exact test) and patients without smoking history (P = 0.025, Fisher’s exact test) were the dominant groups in which any driver mutation was detected. Five patients with driver gene alterations were treated with targeted therapy. Progression-free survival (PFS) was 1.3 months and 1.6 months in 2 of the patients treated with gefitinib. Two patients with the ALK fusion gene showed 2.1 and 14.0 months of PFS from the initiation of treatment with crizotinib, and a patient with the MET exon 14 skipping mutation showed 9.7 months of PFS from the initiation of treatment with tepotinib. Conclusion The EGFR mutation, ALK fusion gene, and MET exon 14 skipping mutation were detected in patients with pulmonary sarcomatoid carcinoma in clinical practice, and some patients achieved long survival times after receiving targeted therapy. Further investigation is necessary to evaluate the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma.

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Phase II study of carboplatin–paclitaxel alone or with bevacizumab in advanced sarcomatoid carcinoma of the lung: HOT1201/NEJ024

Cited by 6 publications

References 20 publications

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

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

Efficacy of immune checkpoint inhibitor therapy in patients with pulmonary sarcomatoid carcinoma in clinical practice

An observational study on the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma

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