The golden key to open mystery boxes of SMARCA4-deficient undifferentiated thoracic tumor: focusing immunotherapy, tumor microenvironment and epigenetic regulation

Xiang Li; Sen Tian; Hui Shi; Na Ta; Xiang Ni; Chenguang Bai; Zhanli Zhu; Yilin Chen; Dongchen Shi; Haidong Huang; Longpei Chen; Zhenhong Hu; Lei Qu; Yao Fang; Chong Bai

doi:10.1038/s41417-024-00732-4

The golden key to open mystery boxes of SMARCA4-deficient undifferentiated thoracic tumor: focusing immunotherapy, tumor microenvironment and epigenetic regulation

Cancer Gene Ther. 2024 Feb 13. doi: 10.1038/s41417-024-00732-4. Online ahead of print.

Authors

Xiang Li^#^{1

2}, Sen Tian^#^{1

3}, Hui Shi⁴, Na Ta⁵, Xiang Ni⁵, Chenguang Bai⁵, Zhanli Zhu¹, Yilin Chen¹, Dongchen Shi¹, Haidong Huang¹, Longpei Chen⁶, Zhenhong Hu², Lei Qu², Yao Fang², Chong Bai⁷

Affiliations

¹ Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Shanghai, China.
² Department of Respiratory and Critical Care Medicine, General Hospital of Central Theater Command of the Chinese People's Liberation Army, Wuhan, China.
³ Department of Respiratory and Critical Care Medicine, No. 906 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Ningbo, China.
⁴ Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Shanghai, China. Huishi@smmu.edu.cn.
⁵ Department of Pathology, the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Shanghai, China.
⁶ Department of Oncology, the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Shanghai, China.
⁷ Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Shanghai, China. Chongbai@smmu.edu.cn.

^# Contributed equally.

PMID: 38347129
DOI: 10.1038/s41417-024-00732-4

Abstract

SMARCA4-deficient undifferentiated thoracic tumor is extremely invasive. This tumor with poor prognosis is easily confused with SMARCA4-deficent non-small cell lung cancer or sarcoma. Standard and efficient treatment has not been established. In this review, we summarized the etiology, pathogenesis and diagnosis, reviewed current and proposed innovative strategies for treatment and improving prognosis. Immunotherapy, targeting tumor microenvironment and epigenetic regulator have improved the prognosis of cancer patients. We summarized clinicopathological features and immunotherapy strategies and analyzed the progression-free survival (PFS) and overall survival (OS) of patients with SMARCA4-UT who received immune checkpoint inhibitors (ICIs). In addition, we proposed the feasibility of epigenetic regulation in the treatment of SMARCA4-UT. To our knowledge, this is the first review that aims to explore innovative strategies for targeting tumor microenvironment and epigenetic regulation and identify potential benefit population for immunotherapy to improve the prognosis.

Publication types

Review