Evidence map›Paper›PMID 40716572›Full record

ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2025

Distinct Clinicogenomic Features and Immunotherapy Associations in Pulmonary Sarcomatoid Carcinoma: A Multicenter Retrospective Study.

Lingzhi Hong, Alessandro Di Federico, Bolun Liu, Alissa J Cooper, Joao V Alessi, Phoebe Clark, Waree Rinsurongkawong, Chingyi Young, Hui Li, Kang Qin and 20 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Lingzhi HongDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Alessandro Di FedericoLowe Center of Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Bolun LiuDepartment of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, Minnesota.
Alissa J CooperDepartment of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Joao V AlessiLowe Center of Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Phoebe ClarkDepartment of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Waree RinsurongkawongDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Chingyi YoungEnt Data Engineering & Analytics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Hui LiDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Kang QinDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Muhammad AminuDepartment of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Valentina SantoLowe Center of Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Yasir ElaminDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Boris SepesiDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jeff LewisDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Don L GibbonsDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ara A VaporciyanDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Jack LeeDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Xiuning LeDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jia WuDepartment of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Sinchita Roy-ChowdhuriDepartment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Mark J RoutbortDepartment of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
P Andrew FutrealDepartment of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
John V HeymachDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Mark M AwadDepartment of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Adam J SchoenfeldDepartment of Thoracic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Jianjun ZhangDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Biagio RicciutiLowe Center of Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Lei DengClinical Research Division, Fred Hutchinson Cancer Center and Department of Medicine, University of Washington, Seattle, Washington.
Natalie I VokesDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: nvokes@mdanderson.org.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DIANE BODURKA · 1985 to 2026
$290.8M
UNIVERSITY OF TEXAS--SPORE IN LUNG CANCERP50CA070907 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI HEYMACH, JOHN V. · 1996 to 2024
$57.4M
Radioimmunogenomic Habitat Phenotypes to Predict Efficacy of Neoadjuvant Immunotherapies in Non-Small Cell Lung CancerR01CA262425 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI CASCONE, TINA, WU, JIA · 2021 to 2025
$3.2M
Integrated blood and radiomic subtyping to guide immunotherapy treatment selection and early response assessment in metastatic non-small cell lung cancerR01CA276178 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Natalie Vokes, Jia Wu · 2023 to 2026
$2.6M
NCI NIH HHS P30 CA008748NCI NIH HHS P30 CA016672NCI NIH HHS P50 CA070907NCI NIH HHS R01 CA262425NCI NIH HHS R01 CA276178
6 · The paper itself

Abstract

introductionPulmonary sarcomatoid carcinoma (PSC) is a rare NSCLC subtype with poor prognosis. Outcomes to immune checkpoint inhibitors (ICIs) and genomic features in PSC remain underexplored compared with other NSCLC subtypes.

methodsPatients from three institutions and the National Cancer Database (NCDB) with metastatic NSCLC treated with ICI alone or with chemotherapy were identified. Clinicogenomics and treatment outcomes were compared across PSC, lung adenocarcinoma (LUAD), and lung squamous cell carcinoma (LUSC).

resultsWe analyzed 4841 patients including 165 PSC cases treated with ICI-based therapy from three institutions and 201 PSC from NCDB. In MDACC, 65 (4.3%) were PSC, 1138 (75.1%) LUAD, and 312 (20.6%) LUSC. Patients with PSC were older and more likely to present with metastatic disease. In both the MDACC and NCDB cohorts, ICIs resulted in better outcomes for patients with PSC compared with chemotherapy. In these patients, there was no difference in outcome between ICI-monotherapy and ICI-chemotherapy. Across the three institutional cohorts, 37% to 43% of patients with PSC who received ICIs were responders, compared with 26% to 29% in LUAD and 22% to 46% in LUSC (p < 0.05). Improved ICI outcomes in PSC appeared driven by high PD-L1 (≥50% in 73%-77% cases). Among patients with high PD-L1, response rates were similar across histologic subtypes. Conversely, TMB was similar in PSC compared with LUAD or LUSC and was not associated with ICI outcomes. Across cohorts, PSC tumors were enriched for TP53, NF1, NF2, and NRAS, with relative depletion of STK11 and KEAP1 compared with LUAD. Case observation revealed relatively better outcomes to ICI than targeted therapies in patients with PSC with MET exon 14 skipping or KRAS G12C.

conclusionPSC exhibits improved outcomes to ICI relative to other therapies, potentially driven by high PD-L1 expression. Genomic analysis highlights a distinct genomic landscape of PSC when compared with LUAD.

Indexed as

Carcinoma, Non-Small-Cell LungImmune Checkpoint InhibitorsImmunotherapyLung NeoplasmsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateImmune Checkpoint InhibitorsGenomicsImmunotherapyKRAS inhibitorsMET inhibitorsNon–small cell lung cancerPulmonary sarcomatoid carcinoma

Identifiers

PMID40716572
PMCPMC12466414

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.