Retrospective study of immune checkpoint inhibitors for advanced pulmonary sarcomatoid carcinoma and predictive potential of TP53 mutations

Patients with advanced pulmonary sarcomatoid carcinoma (PSC) have poor survival due to resistance to chemotherapy and radiotherapy. A retrospective study at the Chinese Academy of Medical Sciences and Peking Union Medical College (Beijing) evaluated the efficacy of immune checkpoint inhibitors (ICIs) for advanced PSC. In tumors tested for PD-L1 expression, 80% had PD-L1 positivity, and 60% had PD-L1 tumor proportion score ≥ 50%. Median overall survival of patients with advanced PSCs receiving anti-PD-1 or PD-L1 antibodies in any line was significantly longer compared to those who did not (NR versus 11.2 months; p=0.015). ICI treatment was an independent favorable factor for the prognosis of advanced OSC patients (HR 0.32; p=0.008). In the subgroup treated with ICI-based therapy, objective response rate was 34.5% and disease control rate was 82.8%. TP53 mutations and PD-L1 TPS ≥ 80% were associated with prolonged progression-free survival (p=0.021; p=0.035) and overall survival (p=0.013; p=0.018). The authors conclude that ICIs were associated with promising outcomes in advanced PSC.