Recent advances in the management of pulmonary sarcomatoid carcinoma

ABSTRACT

Pulmonary sarcomatoid carcinoma (PSC) is a unique and biologically fascinating group of poorly differentiated non-small cell lung cancer (NSCLC), however it is highly aggressive with poor overall survival compared to other types of NSCLC. Radical surgery remains the standard of care for early localized disease but this has shown to result in high recurrence rates. Traditional palliative chemotherapy is associated with poor response in advanced/metastatic PSC. Recent comprehensive genetic studies and clinical observations are starting to elucidate the key oncogenic underpinnings of PSC. In particular, the recent identification of frequent genetic alterations of the MET gene leading to exon 14 skipping have yielded actionable targets for intervention with available MET inhibitors for a subset of PSC patients. Immunotherapy against immune checkpoints, such as anti-PD1/PD-L1 agents, have also raised great interest for the management of PSC. A growing understanding of the molecular pathogenesis of PSC is rapidly yielding novel approaches for the treatment of this deadly malignancy.

KEYWORDS:

• Pulmonary sarcomatoid carcinoma
• MET
• KRAS
• chemotherapy
• targeted therapy
• immunotherapy
• lung cancer

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.