Optimizing palliative chemotherapy for advanced invasive mucinous adenocarcinoma of the lung

Background A primary pulmonary invasive mucinous adenocarcinoma (IMA) is a rare subtype of invasive adenocarcinoma of the lung. The prognosis of advanced IMA depending on chemotherapy regimen has not been fully investigated. Here, we compared the clinical outcomes of patients with advanced IMA treat...

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Bibliographic Details
Published in:BMC cancer 2021-06, Vol.21 (1), p.1-731, Article 731
Main Authors: Jang, Yoon Jung, Hyun, Dong-gon, Choi, Chang-Min, Lee, Dae Ho, Kim, Sang-We, Yoon, Shinkyo, Kim, Woo Sung, Ji, Wonjun, Lee, Jae Cheol
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma of the lung
Cancer
Cancer therapies
Chemotherapy
Classification
Development and progression
Drug therapy
Immunotherapy
Invasiveness
Kinases
Lung cancer
Medical prognosis
Metastases
Metastasis
Methods
Mucinous
Mutation
Palliation
Palliative treatment
Patient outcomes
Patients
Prognosis
Risk factors
Stage IV
Survival
Treatment outcome
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Summary:Background A primary pulmonary invasive mucinous adenocarcinoma (IMA) is a rare subtype of invasive adenocarcinoma of the lung. The prognosis of advanced IMA depending on chemotherapy regimen has not been fully investigated. Here, we compared the clinical outcomes of patients with advanced IMA treated with different palliative chemotherapies that included novel therapeutics. Methods This single-center retrospective study included a total of 79 patients diagnosed with IMA and treated with palliative chemotherapy. The primary outcome was the comparison of overall survival according to palliative chemotherapy type. Risk factors associated with death were evaluated as a secondary outcome. Results The study cohort of 79 patients comprised 27 progressive or recurrent cases and 52 initial metastatic patients. Thirteen patients (16.5%) received targeted therapy and 18 cases (22.8%) received immunotherapy. When we compared the survival outcomes of the different treatment regimens, patients with IMA treated by immunotherapy (undefined vs. non-immunotherapy 17.0 months, p < 0.001) had better overall survival rates. However, there was no difference in the prognosis between the cases treated with a targeted therapy (35.6 vs. non-targeted therapy 17.0 months, p = 0.211). None of the conventional regimens produced a better outcome. By multivariable analysis, immunotherapy (HR 0.28; 95% CI 0.11-0.74; P = 0.008) was found to be an independent prognostic factor for death. Conclusions This study suggests that immunotherapy for patients with advanced IMA may provide favorable outcomes than other chemotherapy options. Keywords: Adenocarcinoma of the lung, Mucinous, Stage IV, Prognosis, Treatment outcome
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-021-08472-6