肺肉瘤样癌的治疗进展

Progress in the Treatment of Pulmonary Sarcomatoid Carcinoma

肺肉瘤样癌(pulmonary sarcomatoid carcinoma,PSC)是非小细胞肺癌的一种罕见亚型,侵袭性高,预后很差。目前尚没有针对PSC的标准疗法,早期患者首选手术,无法手术者需要进一步探索有效疗法,因为PSC对传统化疗及放射治疗不敏感。现推荐对PSC患者进行基因测序及分子生物标志物检测,因为针对特定基因突变患者的靶向治疗可能是有效的,如MET14外显子跳跃突变,程序性死亡配体-1过表达使得免疫治疗在PSC的治疗中也展示出巨大的潜力。由于PSC的高度血管侵袭性,抗血管生成治疗也是潜在有效治疗手段。本文除了总结现有常规治疗手段在PSC中的疗效,针对各种联合抗肿瘤治疗如双靶联合、免疫联合放化疗以及免疫联合抗血管生成治疗、双免联合等在PSC中的最新进展,也进行了详细的阐述。

Pulmonary sarcomatoid carcinoma(PSC)is a rare subtype of non-small cell lung cancer,with a highly aggressive nature and poor prognosis.There is no standard therapy for PSC.Surgery is preferred for early-stage patients,and further exploration of effective therapies is needed for inoperable patients,for PSC is not sensitive to conventional chemotherapy and radiation therapy.Genetic sequencing and molecular biomarker testing are recommended for patients with PSC,because targeted therapy for patients with specific genetic mutations,such as the MET 14 exon skipping mutation,may be effective.Programmed death ligand 1 overexpression also allows immunotherapy to show great potential in the treatment of PSC.Due to high vascular aggression of PSC,anti-angiogenic therapy is also a potential effective treatment.In addition to summarizing the efficacy of existing conventional therapies in PSC,this review also summarizes current advances in various antitumor combination therapies such as dual target combination,immunotherapy combined with chemoradiotherapy,immunotherapy combined with anti-angiogenic therapy and dual immune combination in PSC.