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Immune checkpoint inhibitors (ICIs) have improved the prognosis of patients with non-small cell lung cancer but rarely been explored in pulmonary sarcomatoid carcinoma (PSC). This multicenter study aimed to evaluate the effectiveness of ICIs for PSC and its underlying mechanism. Advanced PSC who received ICIs between August 2018 and May 2022 from 11 centers in China were included. Clinical characteristics and treatment information were collected. Whole-exome sequencing (WES) and whole transcriptome sequencing were conducted on pre-treatment samples to explore the mechanism. 113 patients with PSC were enrolled, the median PFS for patients receiving ICIs therapy was 8.77 months (95 % confidence interval, 4.21 to 13.32). Combining ICIs with anti-angiogenic agents significantly increased PFS (p = 0.04). Liver metastasis and combination therapy with anti-angiogenic agents were independent risk factors for PFS (Hazard Ratio [HR] = 3.652, p = 0.019 and HR = 0.435, p = 0.017, respectively). WES showed that PSC presented with a TMB of 6.3 mutations per million base pairs. High expression of TNFα signaling and glycolysis related gene showed a better prognosis. ICIs showed promising benefits for advanced PSC, and the addition of anti-angiogenic therapy might be a more effective treatment strategy for this disease. • The efficacy of ICIs in PSC was poorly explored. • The mPFS for PSC receiving ICIs was 8.77 m (95 % CI, 4.21-13.32). • The addition of anti-angiogenic therapy with ICIs increased PFS of PSC. • The median TMB of PSC was 6.3 mutations per million base pairs. [ABSTRACT FROM AUTHOR]

At present there is a significant lack of clinical data for patients with surgically resected stage I squamous lung cancer. The purpose of this study was to investigate the impact of postoperative chemotherapy in this specific population. We retrospectively identified patients who had undergone complete squamous lung cancer resection at the Shanghai Chest Hospital between January 2008 and January 2014. A total of 596 patients (236 stage IA, 360 stage IB) were included in this study. Results demonstrated that adjuvant chemotherapy (ACT) could provide longer overall survival for patients with p-stage IB disease (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.34–0.90; p = 0.017). Among p-stage IB patients the ACT-treated cohort trended toward a benefit (HR, 0.69; 95% CI, 0.45–1.04) in recurrence-free survival but failed to reach statistical significance (p = 0.076). After propensity score matching the HRs of recurrence-free survival and overall survival were 0.58 (95% CI, 0.35–0.96; p = 0.033) and 0.49 (95% CI, 0.27–0.88; p = 0.017), respectively. With regards to patients with p-stage IA disease, neither overall survival (HR, 0.87; 95% CI, 0.34–2.27; p = 0.783) nor recurrence-free survival (HR, 0.79; 95% CI, 0.38–1.65; p = 0.534) was significantly different when compared between patients receiving ACT and those who did not. Similar results were also achieved after propensity score matching. The data presented herein demonstrated that ACT might provide survival benefits for squamous lung cancer patients with p-stage IB disease. [ABSTRACT FROM AUTHOR]

Introduction There are a number of uncommon EGFR mutations whose associations with TKIs are not well clarified. Here, we summarize the clinical data of patients with multiple uncommon EGFR mutations and their sensitivity to EGFR TKIs. Methods Between January 2009 and September 2014, we retrospectively examined stage IIIB/IV NSCLC patients harboring uncommon mutations in EGFR at the Shanghai Chest Hospital. Results A total of 123 NSCLC patients harboring uncommon EGFR mutations with treatment and survival details were included in this analysis. 95 Patients who received therapy that consisted of EGFR TKIs experienced a significantly improved overall survival (OS) compared with those who did not receive EGFR TKIs (18.96 months, 95% CI, 16.65–21.26 vs 12.22, 95% CI, 9.17–15.27, p = 0.017). The median progression-free survival (PFS) for patients who harbored the L861Q, G719X, 20ins, Del-19 + L858R, Del-19 or L858R + T790 M, and the Del-19 or L858R + other mutations were 8.90 months (95% CI, 4.47–13.34), 5.98 months (95% CI, 1.53–10.42), 2.00 months (95% CI, 0.00–5.41), 9.53 months (95% CI, 0.00–19.41), 1.94 months (95% CI, 0.00–4.43), and 9.79 months (95% CI, 0.73–18.85), respectively. The best objective response rates (ORRs) for patients who harbored L861Q, G719X, 20ins, Del-19 + L858R, Del-19 or L858R + T790 M, Del-19 or L858R + others were 46.7%, 42.9%, 8.3%, 71.4%, 22.2%, and 55.6%, respectively. Conclusions These results suggest that EGFR TKI therapy is effective in patients with L861Q/G719X/Del-19 + L858R/Del-19 or L858R + other mutations; less effective in patients with 20ins/Del-19 or L858R + T790 M. [ABSTRACT FROM AUTHOR]

• Solid component is a predictive factor of promoted disease progression. • Solid pattern is associated with poor overall survival. • Lung adenocarcinoma patients with solid pattern develop bone metastases earlier. This study aimed to explore the prognostic significance of solid pattern for bone metastases (BM) in epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma patients after surgery. A total of 237 stage I-III lung adenocarcinoma patients with EGFR mutation were analyzed after procedure. The patients were divided into four groups: the solid-present patients with BM, the solid-absent patients with BM, the solid-present patients without BM and the solid-absent patients without BM. The bone disease-free survival (bDFS), systemic disease-free survival (DFS) and overall survival (OS) were assessed. The results revealed that the patients with solid pattern had shorter DFS (15 months vs. 19 months; P < 0.001) and OS (47 months vs. 77 months; P = 0.001). Moreover, bDFS of solid-present patients was significantly shorter than solid-absent patients (27 months vs. 14 months; P < 0.001). In addition, patients with solid component had worsened bDFS, no matter with BM as first-site development (12.5 months vs. 16.5 months; P = 0.016) or non-first-site development (16.5 months vs. 45.5 months; P < 0.001). These findings suggested that solid pattern predicted worse DFS and OS and also showed shortened interval between surgery and BM. [ABSTRACT FROM AUTHOR]

• SCLC/LCNEC was the most common type of C-SCLC. • SCLC/LCNEC patients' DFS and OS were also longer than other combined types. • Adjuvant chemotherapy of EP/EC regiments are the main treatment for surgical C-SCLC. • Patients with increased NSE were significantly associated with longer DFS and OS. • Pleura invasion, lymphatic metastasis, adjuvant chemotherapy were prognostic factors. Small cell lung cancer (SCLC) is the most malignant lung cancer. Some of them are mixed with non-small cell lung cancer(NSCLC, Non SCLC),which are called combined small cell lung cancer (C-SCLC).Due to the difficulty of pathological diagnosis and the complexity of treatment, studies of C-SCLC have just been rising in recent years. This study is to evaluate the clinical and pathologic characteristics of C-SCLC. Stage Ⅰ-Ⅲa C-SCLC patients who received radical R0 surgery between 2009–2018 in Shanghai Chest Hospital were enrolled. Clinical characteristics and prognosis were analyzed. Totally 181 patients were included, most of them were small cell combined with large cell neuroendocrine components(SCLC/LCNEC,58.0 %,N = 105),then with adenocarcinoma(SCLC/ADC:13.8 %,N = 25),and finally with squamous cell carcinoma(SCLC/SCC:13.3 %,N = 24).Median DFS and OS of C-SCLC patients underwent radical surgery were 32.5 and 49.7 months.1,3 and 5 years DFS rates of the entire cohort were 68.5 %,32.6 % and 16.0 %,respectively. Patients with SCLC/LCNEC had longer DFS (44.1 m vs. 20.4 m, p = 0.040) and longer OS trend (62.1 m vs. 33.2 m, p = 0.122).Groups of whether tumor invaded the pleura(p = 0.028 and p = 0.050),lymph node stage(p = 0.029 and p = 0.010) and the courses of adjuvant chemotherapy(p = 0.011 and p = 0.001) had statistical differences on DFS and OS. SCLC/LCNEC was the most common type of C-SCLC. Patients' DFS and OS were also longer than other combined types. Adjuvant chemotherapy for SCLC is still the main treatment for surgical C-SCLC. Further studies are needed to clarify the clinical characteristics and prognosis of C-SCLC. [ABSTRACT FROM AUTHOR]

• MIP was an independent poor prognostic factor for the increase of BM rate. • MIP could shorten the time of BM development after surgery. • MIP was related to the earlier recurrence and shortened survival time. The role of micropapillary pattern (MIP) in EGFR-mutated NSCLC patients with brain metastases (BM) after complete surgical resection still remains unclear. Therefore, a retrospective study was conducted to evaluate the role of MIP in those patients. This study included 332 stage I-III patients with EGFR-mutant lung adenocarcinoma and complete resection. Patients were classified in four groups: the MIP-positive patients without BM development, the MIP-negative patients without BM development, the MIP-positive patients with BM development and the MIP-negative patients with BM development. Intracranial disease-free survival (iDFS), systemic disease-free survival (DFS) and overall survival (OS) were evaluated. The median OS in the whole group was 70 months. The patients with MIP show inferior DFS (13 months vs. 22 months; P < 0.001) and OS (56 months vs. 74 months; P < 0.001). Furthermore, BM development was more likely to be found in patients with MIP (P = 0.001). In addition, the MIP-positive patients showed a significantly shorter iDFS compared with MIP-negative patients (14.5 months vs. 26 months; P < 0.001). Furthermore, the MIP-positive patients had significantly inferior iDFS in both BM as first line development groups (13 months vs. 19 months; P < 0.001) and BM as non-first line development groups (18 months vs. 33 months; P = 0.007). MIP was related to the earlier recurrence and shortened survival time. In addition, MIP was an independent poor prognostic factor for the increase of BM rate and the shortened time of BM development after surgery. [ABSTRACT FROM AUTHOR]

Highlights: [•] NAD+ attenuated DOX-induced increases in SGOT activity and decreases in liver weight. [•] NAD+ attenuated DOX-induced apoptotic changes of the liver. [•] NAD+ decreased DOX-induced dsDNA damage of the liver. [•] NAD+ could decrease DOX-induced liver damage by enhancing antioxidation capacity. [ABSTRACT FROM AUTHOR]