Treatment of Thoracic SMARCA4-Deficient Undifferentiated Tumors: Where We Are and Where We Will Go.
Vito LongoAnnamaria CatinoMichele MontroneElisabetta Sara MontagnaFrancesco PesolaIlaria MarechPamela PizzutiloAnnalisa NardoneAntonella PerroneMonica GesualdoDomenico GalettaPublished in: International journal of molecular sciences (2024)
Recently, the fifth edition of the WHO classification recognized the thoracic SMARCA4 -deficient undifferentiated tumor (SMARCA4-UT) as a separate entity from conventional non-small cell lung cancer with SMARCA4 deficiency because of the different clinicopathological characteristics of these two diseases. SMARCA4-UT mainly occurs in young to middle-aged adults and involves a large mass compressing the tissues surrounding the mediastinum and lung parenchyma. Unfortunately, SMARCA4-UT shows a high probability of recurrence after upfront surgery as well as radiotherapy resistance; moreover, chemotherapy has low efficacy. Moreover, given the recent classification of SMARCA4-UT, no data concerning specific clinical trials are currently available. However, several case reports show immunotherapy efficacy in patients with this disease not only in a metastatic setting but also in a neoadjuvant manner, supporting the development of clinical trials. In addition, preclinical data and initial clinical experiences suggest that inhibiting pathways such as CDK4/6, AURKA, ATR, and EZH2 may be a promising therapeutic approach to SMARCA4-UT.
Keyphrases
- clinical trial
- middle aged
- machine learning
- locally advanced
- squamous cell carcinoma
- spinal cord
- small cell lung cancer
- big data
- rectal cancer
- electronic health record
- early stage
- lymph node
- signaling pathway
- randomized controlled trial
- spinal cord injury
- long non coding rna
- case report
- cell proliferation
- oxidative stress
- dna damage
- phase ii
- cell cycle
- percutaneous coronary intervention
- mesenchymal stem cells
- combination therapy
- artificial intelligence
- study protocol
- replacement therapy