Stereotactic body radiation therapy (SBRT) in the management of pulmonary spindle cell carcinoma

Awobajo, Moyosore; Vaporciyan, Ara A.; Lu, Charles; Gandhi, Saumil

doi:10.1136/bcr-2020-234779

Cited by 5 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The patients still recovered well after a year of follow up. 66 , 76 , 81 However, another study showed one patient with stage IV disease, who had received first-line and second-line chemotherapy, gained no benefit after surgery. After treatment with nivolumab, this patient’s symptoms improved, the brain damage resolved, and reactions occurred at other metastatic sites.…”

Section: Treatmentsmentioning

confidence: 99%

“…65 Stereotactic whole body radiotherapy for primary tumors can only provide general control of local primary lesions but has no obvious advantages for distant metastases and prognoses. 66 However, there are no clear data on the efficacy of radiotherapy for the treatment of PSC, the amount of clinical benefit of radiotherapy that can bring to patients is not known either.…”

Section: Treatmentsmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Liu

et al. 2020

Ther Adv Med Oncol

View full text Add to dashboard Cite

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.

show abstract

Section: Treatmentsmentioning

confidence: 99%

Section: Treatmentsmentioning

confidence: 99%

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Liu

et al. 2020

Ther Adv Med Oncol

View full text Add to dashboard Cite

show abstract

“…Furthermore, an additive platinum doublet in immunotherapy did not improve the overall survival (22). Six reported cases of pulmonary SpCC have been treated with immune checkpoint inhibitors (Table I) (23)(24)(25)(26)(27). Of these cases and the present case, four were diagnosed using surgical specimens and three were diagnosed using biopsy-proven SpCCs.…”

Section: Discussionmentioning

confidence: 99%

Spindle cell carcinoma with cystic brain metastasis: Successful treatment with stereotactic radiotherapy and anti‑programmed cell death‑1 antibodies: A case report

Hamabe¹,

Kuroshima²,

Takaya

et al. 2023

Oncol Lett

View full text Add to dashboard Cite

Cystic brain metastasis is a rare condition that mainly originates from lung or breast adenocarcinomas. By contrast, pulmonary spindle cell carcinoma, a rare type of non-small cell carcinoma, has not been reported with this condition. Cystic brain metastases are characterized by larger tumor sizes with increased peritumoral edema compared with solid metastases. Therefore, specific treatment strategies are required for intracranial disease control. Immunotherapy has recently been demonstrated to be crucial for treating pulmonary sarcomatoid carcinomas based on high programmed cell death-ligand 1 (PD-L1) expression observed in these cancers. The present report describes the case of an 82-year-old man diagnosed with pulmonary spindle cell carcinoma, a rare subtype of sarcomatoid carcinoma. At 7 months after the diagnosis, the patient complained of a walking disturbance for which de novo brain metastasis with peritumoral edema was the causative agent. The brain tumor had a large cystic component, and thus, an Ommaya reservoir catheter was implanted for cyst aspiration but collapsed early without sufficient volume reduction. The patient was transferred to receive twice-split gamma knife treatment, which shrank the solid compartment and reduced the cyst volume, thereby relieving neurological defects. The patient was subsequently treated with immunotherapy targeting programmed cell death-1 based on the high PD-L1 expression in the lung tumor specimen. The thoracic tumors regressed following immunotherapy and progression-free survival was maintained for 16 months. To the best of our knowledge, the present report provides the first description of focal and systemic therapies for pulmonary spindle cell carcinoma with cystic brain metastasis. The report also discusses the treatment strategies for cystic brain metastases and reviews cases of pulmonary spindle cell carcinoma treated with immune checkpoint inhibitors.

show abstract

“…Radiotherapy serves as an important local therapeutic approach for treating patients with NSCLC across all clinical stages. Some studies have reported favorable outcomes among patients with PSC who have undergone radiotherapy ( 125 , 126 ). Gang et al conducted a retrospective analysis of 1,039 patients with PSC using the SEER database and found that radiotherapy was an independent factor associated with a better prognosis for patients with PSC ( 127 ).…”

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

View full text Add to dashboard Cite

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.

show abstract

Stereotactic body radiation therapy (SBRT) in the management of pulmonary spindle cell carcinoma

Cited by 5 publications

References 13 publications

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Pulmonary sarcomatoid carcinoma: progress, treatment and expectations

Spindle cell carcinoma with cystic brain metastasis: Successful treatment with stereotactic radiotherapy and anti‑programmed cell death‑1 antibodies: A case report

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

Contact Info

Product

Resources

About