Comparison of clinical outcomes in patients with advanced pulmonary sarcomatoid carcinoma treated with immunotherapy-based regimens or chemotherapy: A study based on the SEER database and multicentric real-world settings
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Date
2024-12
Journal Title
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Publisher
Wolters Kluwer – Medknow
Abstract
Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare lung cancer characterized by early metastasis and invasion. It is predominantly diagnosed at a locally advanced or metastatic stage, hindering the possibility of surgical intervention. However, a standard treatment for advanced PSC remains unestablished. This study evaluated the effects of chemotherapy and immunotherapy‑based strategies in patients with advanced PSC. Methods: The Surveillance, Epidemiology, and End Results (SEER) database and data from three cancer centers were used in this retrospective study. Progression‑free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Univariate and multivariate analyses were conducted to identify the prognostic factors. Results: In total, 202 patients with stage IV PSC were identified from the SEER database (median OS, 5 months). The median follow‑up time of patients from the three centers was 18.8 months. First‑line treatment with immunotherapy‑based regimens and chemotherapy was administered to 12 and 27 patients, respectively. The median PFS was 2.1 and 7.3 months [hazard ratio (HR), 0.16; 95% confidence interval (CI), 0.06–0.40; P < 0.001], while the median OS was 3.6 and 21.4 months (HR, 0.21; 95% CI, 0.09–0.50; P < 0.001) in the chemotherapy and immune‑based groups, respectively. The immunotherapy‑based regimen was an independent prognostic factor for PFS (HR, 0.21; 95% CI, 0.08–0.55; P = 0.001) and OS (HR, 0.20; 95% CI, 0.08–0.49; P < 0.001). Conclusions: Conventional chemotherapy offered limited benefits in patients with advanced PSC; however, those who received first‑line immunotherapy‑based regimens exhibited significantly improved responses.
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Keywords
Chemotherapy, first‑line treatment, immunotherapy, pulmonary sarcomatoid carcinoma, retrospective analysis
Citation
Peng Duanyang, Xiong Le, Luo Yuxi, Chen Junxing, Zheng Yue’e, Zeng Xiaoli, Liu Shubin, Liu Anwen, Wang Xia, Zeng Zhimin. Comparison of clinical outcomes in patients with advanced pulmonary sarcomatoid carcinoma treated with immunotherapy-based regimens or chemotherapy: A study based on the SEER database and multicentric real-world settings. Journal of Cancer Research and Therapeutics. 2024 Dec; 20(7): 2110-2117