Effectiveness and Safety of Immune Checkpoint Inhibitors Alone or in Combination With Chemotherapy in Pulmonary Sarcomatoid Carcinoma

Daisuke Hazama, MD, PhD; Kenji Nakahama, MD, PhD; Hiroaki Kodama, MD; Akito Miyazaki, MD; Koichi Azuma, MD, PhD; Yosuke Kawashima, MD; Yuki Sato, MD; Kentaro Ito, MD; Yoshimasa Shiraishi, MD; Keita Miura, MD; Takayuki Takahama, MD, PhD; Satoshi Oizumi, MD, PhD; Yoshinobu Namba, MD; Satoshi Ikeda, MD, PhD; Hiroshige Yoshioka, MD, PhD; Asuka Tsuya, MD, PhD; Yuichiro Yasuda, MD, PhD; Yoshiki Negi, MD, PhD; Ayako Hara, MD; Michihito Toda, MD, PhD; Motoko Tachihara, MD, PhD

JTO Clinical and Research Reports (Jan 2024)

Effectiveness and Safety of Immune Checkpoint Inhibitors Alone or in Combination With Chemotherapy in Pulmonary Sarcomatoid Carcinoma

Daisuke Hazama, MD, PhD,
Kenji Nakahama, MD, PhD,
Hiroaki Kodama, MD,
Akito Miyazaki, MD,
Koichi Azuma, MD, PhD,
Yosuke Kawashima, MD,
Yuki Sato, MD,
Kentaro Ito, MD,
Yoshimasa Shiraishi, MD,
Keita Miura, MD,
Takayuki Takahama, MD, PhD,
Satoshi Oizumi, MD, PhD,
Yoshinobu Namba, MD,
Satoshi Ikeda, MD, PhD,
Hiroshige Yoshioka, MD, PhD,
Asuka Tsuya, MD, PhD,
Yuichiro Yasuda, MD, PhD,
Yoshiki Negi, MD, PhD,
Ayako Hara, MD,
Michihito Toda, MD, PhD,
Motoko Tachihara, MD, PhD

Affiliations

Daisuke Hazama, MD, PhD: Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
Kenji Nakahama, MD, PhD: Department of Respiratory Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
Hiroaki Kodama, MD: Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
Akito Miyazaki, MD: Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan
Koichi Azuma, MD, PhD: Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
Yosuke Kawashima, MD: Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
Yuki Sato, MD: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
Kentaro Ito, MD: Respiratory Center, Matsusaka Municipal Hospital, Mie, Japan
Yoshimasa Shiraishi, MD: Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Keita Miura, MD: Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
Takayuki Takahama, MD, PhD: Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
Satoshi Oizumi, MD, PhD: Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan
Yoshinobu Namba, MD: Department of Respiratory Medicine and Medical Oncology, Takarazuka City Hospital, Hyogo, Japan
Satoshi Ikeda, MD, PhD: Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
Hiroshige Yoshioka, MD, PhD: Department of Thoracic Oncology, Kansai Medical University, Osaka, Japan
Asuka Tsuya, MD, PhD: Department of Medical Oncology, Izumi City General Hospital, Osaka, Japan
Yuichiro Yasuda, MD, PhD: Department of Thoracic Oncology, Hyogo Cancer Center, Hyogo, Japan
Yoshiki Negi, MD, PhD: Department of Respiratory Medicine and Hematology, Hyogo Medical University, School of Medicine, Hyogo, Japan
Ayako Hara, MD: Department of Respiratory Medicine, Itami City Hospital, Hyogo, Japan
Michihito Toda, MD, PhD: Department of General Thoracic Surgery, Kansai Rosai Hospital, Hyogo, Japan
Motoko Tachihara, MD, PhD: Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan; Corresponding author. Address for correspondence: Motoko Tachihara, PhD, Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.

Journal volume & issue: Vol. 5, no. 1
p. 100613

Abstract

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Introduction: Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of lung cancer associated with poor prognosis and resistance to conventional chemotherapy. Immune checkpoint inhibitors (ICIs), alone or in combination with chemotherapy, were found to have clinical benefits in PSC in recent studies. Nevertheless, because these studies included a small number of patients owing to disease rarity, larger studies are needed to evaluate the effectiveness and safety of ICI-based therapy for PSC. Methods: This multicenter retrospective study evaluated patients with ICI-naive advanced or metastatic PSC who were treated with ICI-based therapy at 25 hospitals in Japan. Results: A total of 124 patients were evaluated. The overall response rate, median progression-free survival (PFS), and median overall survival (OS) were 59.0%, 10.5 months, and 32.8 months, respectively. The PFS and OS rates at 24 months were 35.3% and 51.5%, respectively. Programmed death-ligand 1 expression, concomitant chemotherapy, and the treatment line were not significantly associated with PFS or OS. Immune-related adverse events (irAEs) were observed in 70 patients (56.5%), including 30 (24.2%) with grade 3 to 5 events. Patients with mild irAEs (grades 1–2) had longer PFS and OS than did those with severe (grades 3–5) or no irAEs. In a multivariate analysis, any-grade irAEs and the absence of liver metastases were independently associated with PFS, whereas any-grade irAEs and Eastern Cooperative Oncology Group performance status less than or equal to 1 were independently associated with OS. Conclusions: ICI-based therapy was found to have promising effectiveness in patients with advanced or metastatic PSC, regardless of programmed death-ligand 1 expression, concomitant chemotherapy, or treatment line.

Published in JTO Clinical and Research Reports

ISSN: 2666-3643 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jto-clinical-and-research-reports/

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