Potential efficacy of anti-angiogenic therapy combined with immunotherapy for advanced SMARCA4-deficient thoracic
Beibei Liu1, Danni Wang1, Yujing Li1
1Department of Pulmonary Medicine, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Background:
As a rare tumor with poor prognosis, the first-line treatment strategy of advanced SMARCA4-deficient thoracic tumors is inconclusive. Although previous studies have shown immunotherapy to be effective, the efficacy and safety of different immune checkpoint inhibitors (ICIs) combination treatment strategies have not been explored in detail. This study aims to identify optimal immunotherapeutic combinations for this population.
Methods:
We collected the clinical and pathological information of 55 patients with SMARCA4-deficient non-small cell lung cancer (SMARCA4-deficient NSCLC) and SMARCA4-deficient undifferentiated tumor (SMARCA4-deficient UT), after which we evaluated and analyzed the survival status and clinicopathological characteristics of the patients.
Results:
Following statistical analysis, it was found that the patients were mainly male smokers with a mean age of 66 years (range, 46-81 years old). Histologically, NSCLC accounts for the majority (n=40, 72.7%). Survival analysis demonstrated that overall survival (OS) was significantly longer in patients who received first-line immunotherapy compared to those who did not receive immunotherapy for first line (21.67 vs. 8.80 months, P=0.003). A trend of prolonged OS was observed in patients who received immunotherapy in the first line compared with those who received immunotherapy in the latter line (21.67 vs. 15.30 months, P=0.14). Furthermore, the OS of patients who received anti-angiogenesis therapy plus immunotherapy was superior to that of patients who received three other first-line treatments [not reached vs. 21.67 months (chemotherapy plus immunotherapy) vs. 8.80 months (chemotherapy plus anti-angiogenesis therapy) vs. 7.83 months (chemotherapy), P=0.02].
Conclusions:
The early use of ICI-based treatment may result in superior survival outcomes for these patients with SMARCA4-deficient thoracic tumors compared to other treatment modalities. Besides, ICIs combined with anti-angiogenesis therapy may be a potential first-line treatment.
Insights
First-line immunotherapy improves survival for advanced SMARCA4-deficient thoracic tumors. Combining immune checkpoint inhibitors with anti-angiogenesis therapy shows promising results as a first-line treatment.
Area of Science:
- Oncology
- Thoracic Surgery
- Medical Oncology
Background:
- SMARCA4-deficient thoracic tumors are rare with poor prognosis, and first-line treatment strategies remain unclear.
- While immunotherapy has shown potential, detailed efficacy and safety of different immune checkpoint inhibitor (ICI) combinations are unexplored.
Purpose of the Study:
- To identify optimal immunotherapeutic combinations for advanced SMARCA4-deficient thoracic tumors.
- To evaluate the efficacy of different treatment strategies, including ICIs and anti-angiogenesis therapy.
Main Methods:
- Retrospective analysis of clinical and pathological data from 55 patients with SMARCA4-deficient non-small cell lung cancer (NSCLC) and undifferentiated tumors (UT).
- Evaluation of survival status and clinicopathological characteristics in relation to treatment modalities.
Main Results:
- First-line immunotherapy significantly improved overall survival (OS) compared to no immunotherapy (21.67 vs. 8.80 months, P=0.003).
- A trend towards prolonged OS was observed with first-line vs. later-line immunotherapy (21.67 vs. 15.30 months, P=0.14).
- Anti-angiogenesis therapy plus immunotherapy demonstrated superior OS compared to other first-line treatments (P=0.02).
Conclusions:
- Early use of ICI-based treatment may lead to superior survival outcomes in SMARCA4-deficient thoracic tumors.
- Combination of ICIs with anti-angiogenesis therapy is a potential first-line treatment option for this patient population.
