Research progress on molecular biology for subtyping and clinical treatment of pulmonary large cell neuroendocrine carcinomas
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摘要: 肺大细胞神经内分泌癌(large cell neuroendocrine carcinoma,LCNEC)发病率较低,占肺恶性肿瘤的2.1%~3.5%,诊断困难,治疗方案的选择尚存争议。LCNEC具有独特的基因谱及转录谱,根据TP53、RB1等基因突变及表达情况可进一步将LCNEC分为RB1野生型和RB1突变型,其中RB1野生型应用非小细胞肺癌(non-small cell lung cancer,NSCLC)常用化疗方案较小细胞肺癌(small cell lung cancer,SCLC)常用方案可显著提高总生存期(overall survival,OS),而RB1突变型应用不同的化疗方案生存均无显著性差异。针对LCNEC的靶向和免疫治疗仅见于小样本的回顾性分析及个案报道。本文对LCNEC相关的分子分型及临床治疗进展予以综述。
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关键词:
- 肺大细胞神经内分泌癌 /
- 基因突变 /
- 化疗 /
- 靶向治疗
Abstract: Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of pulmonary malignant tumors, accounting for only 2.1%-3.5% of all pulmonary malignant tumors. The diagnosis of LCNEC is challenging, especially on small biopsy or cytological samples. Due to limited clinical data, the optimal treatment for LCNEC remains unclear. Recent studies have indicated that LCNEC shave a unique molecular profile and can be further divided into two subtypes:RB1-mutant and RB1-wild type. Patients with RB1-wild type LCNECs showed significant longer overall survival (OS) on treatment with non-small cell lung cancer-related regimens than with small cell lung cancer-related regimens. However, different regimens showed similar effects on RB1-mutant LCNECs. Previously, only retrospective studies and case reports have focused on targeted therapy or immunotherapy against LCNEC. Herein, This article will review the progress of molecular typing and clinical treatment of LCNEC. -
表 1 LCNEC与SCLC临床特征比较
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[1] Fasano M, Della Corte CM, Papaccio F, et al. Pulmonary large-cell neuroendocrine carcinoma:from epidemiology to therapy[J]. J Thorac Oncol, 2015, 10(8):1133-1141. doi: 10.1097/JTO.0000000000000589 [2] Travis WD, Linnoila RI, Tsokos MG, et al. Neuroendocrine tumors of the lung with proposed criteria for large-cell neuroendocrine carcinoma. An ultrastructural, immunohistochemical, and flow cytometric study of 35 cases[J]. Am J Surg Pathol, 1991, 15(6):529-553. doi: 10.1097/00000478-199106000-00003 [3] Travis WD. The 2015 WHO classification of lung tumors[J]. Pathologe, 2014, 35(Suppl 2):188. http://d.old.wanfangdata.com.cn/Periodical/qlzlzz201601013 [4] Kinslow CJ, May MS, Saqi A, et al. Large-cell neuroendocrine carcinoma of the lung:A population-based study[J]. Clin Lung Cancer, 2020, 21(2):99-113. doi: 10.1016/j.cllc.2019.07.011 [5] Hiroshima K, Mino-Kenudson M. Update on large cell neuroendocrine carcinoma[J]. Transl Lung Cancer Res, 2017, 6(5):530-539. doi: 10.21037/tlcr.2017.06.12 [6] Vollbrecht C, Werner R, Walter RF, et al. Mutational analysis of pulmonary tumours with neuroendocrine features using targeted massive parallel sequencing:a comparison of a neglected tumour group[J]. Br J Cancer, 2015, 113(12):1704-1711. doi: 10.1038/bjc.2015.397 [7] Rekhtman N, Pietanza MC, Hellmann MD, et al. Next-generation sequencing of pulmonary large cell neuroendocrine carcinoma reveals small cell carcinoma-like and non-small cell carcinoma-like subsets[J]. Clin Cancer Res, 2016, 22(14):3618-3629. doi: 10.1158/1078-0432.CCR-15-2946 [8] Derks JL, van Suylen RJ, Thunnissen E, et al. Chemotherapy for pulmonary large cell neuroendocrine carcinomas:does the regimen matter[J]? Eur Respir J, 2017, 49(6):1601838. doi: 10.1183/13993003.01838-2016 [9] Karlsson A, Brunnstrom H, Micke P, et al. Gene expression profiling of large cell lung cancer links transcriptional phenotypes to the new histological WHO 2015 classification[J]. J Thorac Oncol, 2017, 12(8):1257-1267. doi: 10.1016/j.jtho.2017.05.008 [10] Simbolo M, Barbi S, Fassan M, et al. Gene expression profiling of lung atypical carcinoids and large cell neuroendocrine carcinomas identifies three transcriptomic subtypes with specific genomic alterations[J]. J Thorac Oncol, 2019, 14(9):1651-1661. doi: 10.1016/j.jtho.2019.05.003 [11] Zhou Z, Zhu L, Lu S, et al. MA11.01 Molecular profiling of large cell neuroendocrine carcinoma using capture-based targeted sequencing[J]. J Thorac Oncol, 2017, 12(1 Suppl):S403-S404. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=d8f2475f1804b1d133bcc06570f80860 [12] Manrique TG, Benítez AMV, Zarco ER, et al. Testing EGFR and ALK in large cell neuroendocrine carcinoma of the lung, Looking for biological features in rare tumors[J]. J Thorac Oncol, 2017, 12(11 Suppl 2):S2254. [13] Matsumura Y, Umemura S, Ishii G, et al. Expression profiling of receptor tyrosine kinases in high-grade neuroendocrine carcinoma of the lung:a comparative analysis with adenocarcinoma and squamous cell carcinoma[J]. J Cancer Res Clin Oncol, 2015, 141(12):2159-2170. doi: 10.1007/s00432-015-1989-z [14] Miyoshi T, Umemura S, Matsumura Y, et al. Genomic profiling of largecell neuroendocrine carcinoma of the lung[J]. Clin Cancer Res, 2017, 23(3):757-765. doi: 10.1158/1078-0432.CCR-16-0355 [15] Sabari J, Rudin C, Rekhtman N. Clinical outcomes of patients with pulmonary large cell neuroendocrine carcinoma characterized by nextgeneration sequencing:topic:medical oncology[J]. J Thorac Oncol, 2016, 11(11 Suppl):S283. [16] George J, Walter V, Peifer M, et al. Integrative genomic profiling of largecell neuroendocrine carcinomas reveals distinct subtypes of highgrade neuroendocrine lung tumors[J]. Nat Commun, 2018, 9(1):1048. [17] Pelosi G, Barbareschi M, Cavazza A, et al. Large cell carcinoma of the lung:a tumor in search of an author. A clinically oriented critical reappraisal[J]. Lung Cancer, 2015, 87(3):226-231. doi: 10.1016/j.lungcan.2015.01.008 [18] Zhuo M, Guan Y, Yang X, et al. The prognostic and therapeutic role of genomic subtyping by sequencing tumor or cell-free DNA in pulmonary large-cell neuroendocrine carcinoma[J]. Clin Cancer Res, 2020, 26(4):892-901. http://cn.bing.com/academic/profile?id=e015b46a76fd8d882cff8a8f885843e8&encoded=0&v=paper_preview&mkt=zh-cn [19] Karlsson A, Brunnstrom H, Lindquist KE, et al. Mutational and gene fusion analyses of primary large cell and large cell neuroendocrine lung cancer[J]. Oncotarget, 2015, 6(26):22028-22037. https://www.researchgate.net/publication/279629723_Mutational_and_gene_fusion_analyses_of_primary_large_cell_and_large_cell_neuroendocrine_lung_cancer [20] Jiang Y, Lei C, Zhang X, et al. Double-edged role of radiotherapy in patients with pulmonary large-cell neuroendocrine carcinoma[J]. J Cancer, 2019, 10(25):6422-6430. doi: 10.7150/jca.32446 [21] Hanna N, Johnson D, Temin S, et al. Systemic therapy for stage Ⅳ nonsmall-cell lung cancer:American Society of Clinical Oncology clinical practice guideline update[J]. J Oncol Pract, 2017, 35(30):3484-3515. https://www.researchgate.net/publication/321924401_Stereotactic_Body_Radiotherapy_for_Early-Stage_Non-Small-Cell_Lung_Cancer_American_Society_of_Clinical_Oncology_Endorsement_of_the_American_Society_for_Radiation_Oncology_Evidence-Based_Guideline_Summ [22] Iyoda A, Hiroshima K, Moriya Y, et al. Prospective study of adjuvant chemotherapy for pulmonary large cell neuroendocrine carcinoma[J]. Ann Thorac Surg, 2006, 82(5):1802-1807. doi: 10.1016/j.athoracsur.2006.05.109 [23] Kujtan L, Muthukumar V, Kennedy KF, et al. The role of systemic therapy in the management of stageⅠlarge cell neuroendocrine carcinoma of the lung[J]. J Thorac Oncol, 2018, 13(5):707-714. doi: 10.1016/j.jtho.2018.01.019 [24] Rossi G, Cavazza A, Marchioni A, et al. Role of chemotherapy and the receptor tyrosine kinases KIT, PDGFRalpha, PDGFRbeta, and Met in large-cell neuroendocrine carcinoma of the lung[J]. J Clin Oncol, 2005, 23(34):8774-8785. doi: 10.1200/JCO.2005.02.8233 [25] Zhang JT, Li Y, Yan LX, et al. Disparity in clinical outcomes between pure and combined pulmonary large-cell neuroendocrine carcinoma:A multi-center retrospective study[J]. Lung Cancer, 2020, 139:118-123. doi: 10.1016/j.lungcan.2019.11.004 [26] Eba J, Kenmotsu H, Tsuboi M, et al. A Phase Ⅲ trial comparing irinotecan and cisplatin with etoposide and cisplatin in adjuvant chemotherapy for completely resected pulmonary high-grade neuroendocrine carcinoma (JCOG1205/1206)[J]. Jap J Clin Oncol, 2014, 44(4):379-382. doi: 10.1093/jjco/hyt233 [27] Naidoo J, Santos-Zabala ML, Iyriboz T, et al. Large cell neuroendocrine carcinoma of the lung:clinico-pathologic features, treatment, and outcomes[J]. Clin Lung Cancer, 2016, 17(5):e121-e129. doi: 10.1016/j.cllc.2016.01.003 [28] Niho S, Kenmotsu H, Sekine I, et al. Combination chemotherapy with irinotecan and cisplatin for large-cell neuroendocrine carcinoma of the lung:a multicenter phase Ⅱ study[J]. J Thorac Oncol, 2013, 8(7):980-984. doi: 10.1097/JTO.0b013e31828f6989 [29] Metro G, Ricciuti B, Chiari R, et al. Survival outcomes and incidence of brain recurrence in high-grade neuroendocrine carcinomas of the lung:Implications for clinical practice[J]. Lung Cancer, 2016, (95):82-87. http://cn.bing.com/academic/profile?id=b849bb61ea29d7a1fcbfe9fb25527b4a&encoded=0&v=paper_preview&mkt=zh-cn [30] Sun JM, Ahn MJ, Ahn JS, et al. Chemotherapy for pulmonary large cell neuroendocrine carcinoma:similar to that for small cell lung cancer or non-small cell lung cancer[J]? Lung Cancer, 2012, 77(2):365-370. doi: 10.1016/j.lungcan.2012.04.009 [31] Derks JL, Leblay N, Thunnissen E, et al. Molecular subtypes of pulmonary large-cell neuroendocrine carcinoma predict chemotherapy treatment outcome[J]. Clin Cancer Res, 2018, 24(1):33-42. doi: 10.1158/1078-0432.CCR-17-1921 [32] Ito M, Miyata Y, Hirano S, et al. Therapeutic strategies and genetic profile comparisons in small cell carcinoma and large cell neuroendocrine carcinoma of the lung using next-generation sequencing[J]. Oncotarget, 2017, 8(65):108936-108945. http://cn.bing.com/academic/profile?id=d712af7dbc988903eef163a93a14206d&encoded=0&v=paper_preview&mkt=zh-cn [33] Francesca A. Tyrosine kinase inhibitors in EGFR-mutated large-cell neuroendocrine carcinoma of the lung? A case report[J]. Case Rep Oncol, 2014, 7(2):478-483. doi: 10.1159/000365413 [34] Le X, Desai NV, Majid A, et al. De novo pulmonary small cell carcinomas and large cell neuroendocrine carcinomas harboring EGFR mutations:Lack of response to EGFR inhibitors[J]. Lung Cancer, 2015, 88(1):70-73. doi: 10.1016/j.lungcan.2015.02.003 [35] Omachi N. A case of large-cell neuroendocrine carcinoma harboring an EML4-ALK rearrangement with resistance to the ALK inhibitor crizotinib[J]. J Thorac Oncol, 2014, 9(6):e40-e42. doi: 10.1097/JTO.0000000000000103 [36] Shimizu N, Akashi Y, Fujii T, et al. Use of ALK immunohistochemistry for optimal therapeutic strategy of pulmonary large-cell neuroendocrine carcinoma and identification of a novel KIF5B-ALK fusion oncokinase[J]. Anticancer Res, 2019, 39(1):413-420. doi: 10.21873/anticanres.13127 [37] Coleman N, Wotherspoon A, Yousaf N, et al. Transformation to neuroendocrine carcinoma as a resistance mechanism to lorlatinib[J]. Lung Cancer, 2019, 134:117-120. doi: 10.1016/j.lungcan.2019.05.025 [38] Christopoulos P, Engel-Riedel W, Grohe C, et al. Everolimus with paclitaxel and carboplatin as first-line treatment for metastatic large-cell neuroendocrine lung carcinoma:a multicenter phaseⅡ trial[J]. Ann Oncol, 2017, 28(8):1898-1902. doi: 10.1093/annonc/mdx268 [39] Saunders LR, Bankovich AJ, Anderson WC, et al. A DLL3-targeted antibody-drug conjugate eradicates high-grade pulmonary neuroendocrine tumor-initiating cells in vivo[J]. Sci Transl Med, 2015, 7(302):302ra136. doi: 10.1126/scitranslmed.aac9459 [40] Rudin CM, Pietanza MC, Bauer TM, et al. Rovalpituzumab tesirine, a DLL3-targeted antibody-drug conjugate, in recurrent small-cell lung cancer:a first-in-human, first-in-class, open-label, phase 1 study[J]. Lancet Oncol, 2017, 18(1):42-51. doi: 10.1016/S1470-2045(16)30565-4 [41] Odate S, Nakamura K, Onishi H, et al. TrkB/BDNF signaling pathway is a potential therapeutic target for pulmonary large cell neuroendocrine carcinoma[J]. Lung Cancer, 2013, 79(3):205-214. doi: 10.1016/j.lungcan.2012.12.004 [42] Drilon A, Laetsch TW, Kummar S, et al. Efficacy of larotrectinib in TRK fusion-positive cancers in adults and children[J]. New Engl J Med, 2018, 378(8):731-739. doi: 10.1056/NEJMoa1714448 [43] Hellmann MD, Callahan MK, Awad MM, et al. Tumor mutational burden and efficacy of nivolumab monotherapy and in combination with ipilimumab in small-cell lung cancer[J]. Cancer Cell, 2018, 33(5):853-861. doi: 10.1016/j.ccell.2018.04.001 [44] Tsuruoka K, Horinouchi H, Goto Y, et al. PD-L1 expression in neuroendocrine tumors of the lung[J]. Lung Cancer, 2017, 108:115-120. doi: 10.1016/j.lungcan.2017.03.006 [45] Levra MG, Mazieres J, Valette CA, et al. P1.07-012 Efficacy of immune checkpoint inhibitors in large cell neuroendocrine lung cancer:results from a french retrospective cohort:topic:drug treatment alone and in combination with radiotherapy[J]. J Thorac Oncol, 2017, 12(1 Suppl):S702-S703. http://cn.bing.com/academic/profile?id=2d7e0f3f4dadd7aa85c3c47a7946b385&encoded=0&v=paper_preview&mkt=zh-cn [46] Patel SP, Othus M, Chae YK, et al. A phaseⅡ basket trial of dual antiCTLA-4 and anti-PD-1 blockade in rare tumors (DART SWOG 1609) in patients with non-pancreatic neuroendocrine tumors[J]. Clin Cancer Res, 2020.Doi: 10.1158/1078-0432.CCR-19-3356.
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