Pulmonary sacromatiod carcinoma is a non-small cell lung cancer that contains a component of sarcoma or sarcoma-like differentiation, with an incidence of 2% to 3% of the total non-small cell lung cancer. They are poorly differentiated, highly invasive and insensitive to platinum-based chemotherapy. Due to its limited treatment, it has always caused significant difficulty in clinical work. A variety of gene mutations have been found in pulmonary sarcomatoid carcinomas, including TP53, EGFR, KRAS, MET and ALK, as well as high PD-L1 positive rates in recent studies. These molecular characteristics are expected to bring new hope for targeted therapy of pulmonary sarcomatoid carcinomas. This review focuses on pulmonary sarcomatoid carcinoma.
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Progress in molecular pathology and targeted therapy of pulmonary sacromatiod carcinoma
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1. Travis WD, Brambilla E, Burke AP, et al. Introduction to the 2015 World Health Organization classification of tumors of the lung, pleura, thymus, and heart[J]. J Thorac Oncol, 2015, 10(9): 1240-1242. DOI: 10.1097/JTO.0000000000000663.
2. Yendamuri S, Caty L, Pine M, et al. Outcomes of sarcomatoid carcinoma of the lung: a surveillance, epidemiology, and end results database analysis[J]. Surgery, 2012, 152(3): 397-402. DOI: 10.1016/j.surg. 2012.05.007.
3. Cates JM, Dupont WD, Barnes JW, et al. Markers of epithelial-mesenchymal transition and epithelial differentiation in sarcomatoid carcinoma: utility in the differential diagnosis with sarcoma[J]. Appl Immunohistochem Mol Morphol, 2008, 16(3): 251-262. DOI: 10.1097/PAI.0b013e318156e9b4.
4. Bae HM, Min HS, Lee SH, et al. Palliative chemotherapy for pulmonary pleomorphic carcinoma[J]. Lung Cancer, 2007, 58(1): 112-115. DOI: 10.1016/j.lungcan.2007.05. 006.
5. Liu X, Jia Y, Stoopler MB, et al. Next-generation sequencing of pulmonary sarcomatoid carcinoma reveals high frequency of actionable MET gene mutations[J]. J Clin Oncol, 2016, 34(8): 794-802. DOI: 10.1200/JCO.2015.62.0674.
6. Fallet V, Saffroy R, Girard N, et al. High-throughput somatic mutation profiling in pulmonary sarcomatoid carcinomas using the LungCarta™ Panel: exploring therapeutic targets[J]. Ann Oncol, 2015, 26(8): 1748-1753. DOI: 10.1093/annonc/mdv232.
7. Maneenil K, Xue Z, Liu M, et al. Sarcomatoid carcinoma of the lung: the mayo clinic experience in 127 patients[J]. Clin Lung Cancer, 2018, 19(3): e323-e333. DOI: 10.1016/j.cllc.2017.12.008.
8. Wang S, Chen R, Tang Y, et al. Comprehensive genomic profiling of rare tumors: routes to targeted therapies[J/OL]. Frontiers in Oncology, 2020. [Access on 2020-07-15]. DOI: 10.3389/fonc.2020.00536.
9. 王恩华,张杰. 临床病理诊断与鉴别诊断——气管、肺、胸膜及纵隔疾病[M]. 北京:人民卫生出版社,2018. [Wang EH, Zhang J. Clinicopathological diagnosis and differential diagnosis-diseases of trachea, lung, pleura and mediastinum[M]. Beijing: People's Medical Publishing House, 2018.]
10. Chang YL, Wu CT, Shih JY, et al. EGFR and p53 status of pulmonary pleomorphic carcinoma: implications for EGFR tyrosine kinase inhibitors therapy of an aggressive lung malignancy[J]. Ann Surg Oncol, 2011, 18(10): 2952-2960. DOI: 10.1245/s10434-011-1621-7.
11. Terra SB, Jang JS, Bi L, et al. Molecular characterization of pulmonary sarcomatoid carcinoma: analysis of 33 cases[J]. Mod Pathol, 2016, 29(8): 824-831. DOI: 10.1038/modpathol.2016.89.
12. Liang X, Li Q, Xu B, et al. Mutation landscape and tumor mutation burden analysis of Chinese patients with pulmonary sarcomatoid carcinomas[J]. Int J Clin Oncol, 2019, 24(9): 1061-1068. DOI: 10.1007/s10147-019-01454-6.
13. Lococo F, Gandolfi G, Rossi G, et al. Deep sequencing analysis reveals that kras mutation is a marker of poor prognosis in patients with pulmonary sarcomatoid carcinoma[J]. J Thorac Oncol, 2016, 11(8): 1282-1292. DOI: 10.1016/j.jtho.2016.04.020.
14. Travis WD. Sarcomatoid neoplasms of the lung and pleura[J]. Arch Pathol Lab Med, 2010, 134(11): 1645-1658. DOI: 10.1043/2010-0086-RAR.1.
15. Kaira K, Horie Y, Ayabe E, et al. Pulmonary pleomorphic carcinoma: a clinicopathological study including EGFR mutation analysis[J]. J Thorac Oncol, 2010, 5(4): 460-465. DOI: 10.1097/JTO.0b013e3181ce3e3c.
16. Pelosi G, Gasparini P, Cavazza A, et al. Multiparametric molecular characterization of pulmonary sarcomatoid carcinoma reveals a nonrandom amplification of anaplastic lymphoma kinase (ALK) gene[J]. Lung Cancer, 2012, 77(3): 507-514. DOI: 10.1016/j.lungcan.2012.05.093.
17. Jiang X, Liu Y, Chen C, et al. The value of biomarkers in patients with sarcomatoid carcinoma of the lung: molecular analysis of 33 cases[J]. Clin Lung Cancer, 2012, 13(4): 288-296. DOI: 10.1016/j.cllc.2011.11.004.
18. Sim JK, Chung SM, Choi JH, et al. Clinical and molecular characteristics of pulmonary sarcomatoid carcinoma[J]. Korean J Intern Med, 2018, 33(4): 737-744. DOI: 10.3904/kjim.2017.245.
19. Schrock AB, Li SD, Frampton GM, et al. Pulmonary sarcomatoid carcinomas commonly harbor either potentially targetable genomic alterations or high tumor mutational burden as observed by comprehensive genomic profiling[J]. J Thorac Oncol, 2017, 12(6): 932-942. DOI: 10.1016/j.jtho.2017.03.005.
20. Pécuchet N, Vieira T, Rabbe N, et al. Molecular classification of pulmonary sarcomatoid carcinomas suggests new therapeutic opportunities[J]. Ann Oncol, 2017, 28(7): 1597-1604. DOI: 10.1093/annonc/mdx162.
21. Mehrad M, Roy S, Laframboise WA, et al. Kras mutation is predictive of outcome in patients with pulmonary sarcomatoid carcinoma[J]. Histopathology, 2018, 73(2): 207-214. DOI: 10.1111/his.13505.
22. Pelosi G, Gasparini P, Conte D, et al. Synergistic activation upon met and ALK coamplification sustains targeted therapy in sarcomatoid carcinoma, a deadly subtype of lung cancer[J]. J Thor Oncol, 2016, 11(5): 718-728. DOI: 10.1016/j.jtho.2016.01.009.
23. Yu Y, Zhang Q, Zhang J, et al. Prevalence of MET exon 14 skipping mutation in pulmonary sarcomatoid carcinoma patients without common targetable mutations: a single-institute study[J]. J Cancer Res Ther, 2019, 15(4): 909-913. DOI: 10.4103/jcrt.JCRT_591_18.
24. Li Y, Gao L, Ma D, et al. Identification of MET exon14 skipping by targeted DNA- and RNA-based next-generation sequencing in pulmonary sarcomatoid carcinomas[J]. Lung Cancer, 2018, 122: 113-119. DOI: 10.1016/j.lungcan.2018.06.001.
25. Chen X, Zhang Y, Lu J, et al. Pulmonary sarcomatoid carcinoma with ALK rearrangement: frequency, clinical-pathologic characteristics, and response to ALK inhibitor[J]. Transl Oncol, 2017, 10(2): 115-120. DOI: 10.1016/j.tranon.2016.11.009.
26. Brahmer JR, Tykodi SS, Chow LQM, et al. Safety and activity of anti-PD-L1 antibody in patients with advanced cancer[J]. N Engl J Med, 2012, 366(26): 2455-2465. DOI: 10.1056/NEJMoa1200694.
27. Velcheti V, Rimm DL, Schalper KA. Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) [J]. J Thor Oncol, 2013, 8(6): 803-805. DOI: 10.1097/JTO.0b013e318292be18.
28. Kim S, Kim MY, Koh J, et al. Programmed death-1 ligand 1 and 2 are highly expressed in pleomorphic carcinomas of the lung: comparison of sarcomatous and carcinomatous areas[J]. Eur J Cancer, 2015, 51(17): 2698-2707. DOI: 10.1016/j.ejca.2015.08.013.
29. 张子涵, 张中冕, 李静, 等. 肺肉瘤样癌高表达PD-L1、RAB1A及其临床意义[J]. 实用医学杂志, 2018, 34(7): 1059-1063. DOI: 10.3969/j.issn.1006-5725. 2018.07.004. [Zhang ZH, Zhang ZM, Li J, et al. Significance of the high expression of PD-L1 and RAB1A in pulmonary sarcomatoid carcinoma[J]. The Journal of Practical Medicine, 2018, 34(7): 1059-1063.]
30. Vieira T, Antoine M, Hamard C, et al. Sarcomatoid lung carcinomas show high levels of programmed death ligand-1 (PD-L1) and strong immune-cell infiltration by TCD3 cells and macrophages[J]. Lung Cancer, 2016, 98: 51-58. DOI: 10.1016/j.lungcan.2016.05.013.
31. Lococo F, Torricelli F, Rossi G, et al. Inter-relationship between PD-L1 expression and clinic-pathological features and driver gene mutations in pulmonary sarcomatoid carcinomas[J]. Lung Cancer, 2017, 113: 93-101. DOI: 10.1016/j.lungcan.2017.09.009.
32. Nakagomi T, Goto T, Hirotsu Y, et al. New therapeutic targets for pulmonary sarcomatoid carcinomas based on their genomic and phylogenetic profiles[J]. Oncotarget, 2018, 9(12): 10635-10649. DOI: 10.18632/oncotarget.24365.
33. Rizvi NA, Hellmann MD, Snyder A, et al. Mutational landscape determines sensitivity to PD-1 blockade in non-small cell lung cancer[J]. Science, 2015, 348(6230): 124-128. DOI: 10.1126/science.aaa1348.
34. Bi M, Zhao S, Said JW, et al. Genomic characterization of sarcomatoid transformation in clear cell renal cell carcinoma[J]. Proc Natl Acad Sci U S A, 2016, 113(8): 2170-2175. DOI: 10.1073/pnas.1525735113.
35. Ge J, Yao B, Huang J, et al. Molecular genetic characterization reveals linear tumor evolution in a pulmonary sarcomatoid carcinomas patient with a novel phf20-ntrk1 fusion: a case report[J]. BMC Cancer, 2019, 19(1): 592. DOI: 10.1186/s12885-019-5780-4.
36. Bykov VJ, Issaeva N, Shilov A, et al. Restoration of the tumor suppressor function to mutant p53 by a low-molecular-weight compound[J]. Nat Med, 2002, 8(3): 282-288. DOI: 10.1038/nm0302-282.
37. Tamura Y, Fujiwara Y, Yamamoto N, et al. Retrospective analysis of the efficacy of chemotherapy and molecular targeted therapy for advanced pulmonary pleomorphic carcinoma[J]. BMC Res Notes, 2015, 8(1): 800. DOI: 10.1186/s13104-015-1762-z.
38. Zou F, Xie G, Ma JA, et al. Epidermal growth factor receptor mutation heterogeneity analysis of pulmonary sarcomatoid carcinoma successfully treated with erlotinib: a case report[J]. Oncol Lett, 2015, 9(5): 2239-2243. DOI: 10.3892/ol.2015.3057.
39. Fakih M, O'Neil B, Price TJ, et al. Phase 1 study evaluating the safety, tolerability, pharma-cokinetics (PK), and efficacy of AMG 510, a novel small molecule KRASG12C inhibitor, in advanced solid tumors[J]. J Clin Oncol, 2019, 37(15): 3003. DOI: 10.1200/JCO.2019.37.15_suppl.3003.
40. Pelosi G, Scarpa A, Manzotti M, et al. K-ras gene mutational analysis supports a monoclonal origin of biphasic pleomorphic carcinoma of the lung[J]. Mod Path, 2004, 17(5): 538-546. DOI: 10.1038/modpathol.3800058.
41. Li X, Zhang Z, Liu J, et al. Molecular features of giant-cell carcinoma of the lung: a case report and literature review[J]. Onco Targets Ther, 2018, 11: 751. DOI: 10.2147/OTT.S150124.
42. Mansfield AS, Roden AC, Boland JM. Towards a molecular classification of pulmonary sarcomatoid carcinomas[J]. J Thorac Oncol, 2017, 12(6): 910-912. DOI: 10.1016/j.jtho.2017.04.012.
43. Tong JH, Yeung SF, Chan AW, et al. MET amplification and exon 14 splice site mutation define unique molecular subgroups of non-small cell lung carcinoma with poor prognosis[J]. Clin Cancer Res, 2016, 22(12): 3048-3056. DOI: 10.1158/1078-0432.CCR-15-2061.
44. Lin L, Huang F, Chen F, et al. Anaplastic lymphoma kinase (ALK)-rearranged pulmonary pleomorphic carcinoma successfully treated with crizotinib[J]. J Int Med Res, 2018, 46(8): 3491-3497. DOI: 10.1177/0300060517748262.
45. Chen F, Gu Q, Hu C, et al. Poor prognosis of pulmonary sarcomatoid carcinoma with KRAS mutation and ALK fusion[J]. Onco Targets Ther, 2019, 12: 3321-3325. DOI: 10.2147/OTT.S196751.
46. Reck M, Rodríguez-Abreu D, Robinson AG, et al. Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer[J]. N Engl J Med, 2016, 375(19): 1823-1833. DOI: 10.1056/NEJMoa1606774.
47. Cimpeanu E, Ahmed J, Zafar W, et al. Pembrolizumab - emerging treatment of pulmonary sarcomatoid carcinoma: a case report[J]. World J Clin Cases, 2020, 8(1): 97-102. DOI: 10.12998/wjcc.v8.i1.97.
48. Domblides C, Leroy K, Monnet I, et al. Efficacy of immune checkpoint inhibitors in lung sarcomatoid carcinoma[J]. J Thorac Oncol, 2020, 15(5): 860-866. DOI: 10.1016/j.jtho.2020.01.014.
49. Babacan NA, Pina IB, Signorelli D, et al. Relationship between programmed death receptor-ligand 1 expression and response to checkpoint inhibitor immunotherapy in pulmonary sarcomatoid carcinoma: a pooled analysis[J]. Clin Lung Cancer, 2020, 21(5): e456-e463. DOI: 10.1016/j.cllc.2020.02.022.
50. Majeti R, Chao MP, Alizadeh AA, et al. CD47 is an adverse prognostic factor and therapeutic antibody target on human acute myeloid leukemia stem cells[J]. Cell, 2009, 138(2): 286-299. DOI: 10.1016/j.cell.2009.05.045.
51. Chao MP, Alizadeh AA, Tang C, et al. Anti-CD47 antibody synergizes with rituximab to promote phagocytosis and eradicate non-hodgkin lymphoma[J]. Cell, 2010, 142(5): 699-713. DOI: 10.1016/j.cell.2010.07.044.
52. Yang Z, Xu J, Li R, et al. PD-L1 and CD47 co-expression in pulmonary sarcomatoid carcinoma: a predictor of poor prognosis and potential targets of future combined immunotherapy[J]. J Cancer Res Clin Oncol, 2019, 145(12): 3055-3065. DOI: 10.1007/s00432-019-03023-w.
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