Sarcomatoid Carcinoma - 1260900

I don't have those numbers for you; I don't think any of our faculty members would. Sarcomatoid carcinoma is too rare to have published stats like that.

Patients with sarcomatoid carcinoma may be eligible for some trials of non-small cell lung cancer. I don't know of any trials just for this entity, as uncommon/rare as it is, but you may want to search the clinicaltrials.gov website to see if there are specific trials that are enrolling patients with this histology.

Good luck.

-Dr. West

I have been told I have sarcomatoid carcinoma of the lung (diagnosed April 2011). I am in a clinical trial for an anti-PD-1 drug (MK 3475 or lambrolizumab), which has done really well for me so far. I just had a hip replacement for a bone metastasis, but other than that I have a pretty normal life and no cancer symptoms. Dr. Rimm at Yale has done some reserach on this:

http://www.oncologynurseadvisor.com/targeted-therapies-have-potential-f…

Fantastic Feisty! Thanks!

Yes, I'd say that research with immune checkpoint inhibitors (anti-PD1 or anti-PDL1) has been the most promising avenue in treatment of sarcomatoid carcinoma that I know of...still early days, but really encouraging.

-Dr. West

Pencilfoot,

My wife also has sarcomatoid carcinoma (diagnosed as spindle cell carcinoma) and was first diagnosed in September, 2012. Based on FeistyD's experience on the Merck trial, and my wife having the same rare cancer, I have pushed to get my wife on the Merck trial for the past 6 months. Because the trial required progression after induction chemo with a platinum doublet, we had to go through 6 months of carbo/taxol/avastin and see how she responded. We both hated having to do that, due to the difficultly in handling traditional chemo. When she was scanned after the 6 months and showed progression, she became eligible for enrollment into the Merck anti-pd1 trial. Next hurdle was having another biopsy to see if she expressed the PDL1 ligand, without which, we would not be eligible for most (but not all) anti-pd1 trials. Thank goodness she did have the ligand and we started the Merck trial this past Halloween. She is going for her fourth infusion tomorrow and has had no real side effects. She feels great after stopping the carbo/taxol/avastin and we are hoping for a good first scan in January.

Moral of the story? You have to carefully look trough all the anti-pd1 clinical trials to look for the inclusion and exclusion criteria and plan your treatment around these criteria. I'm not aware of any anti-pd1 trials that allow "chemo naive" enrollment (allowing people in that have not had any chemo). There were a few openings in the Merck trial, but those spaces were taken some time ago. That leaves you with having to take traditional chemo for 4-6 months before you can even be considered.

There is only anecdotal evidence so far, but getting into an anti-pd1 trial is likely the best alternative of there being some good response to our rare cancers. As far as percent survival is concerned, don't go there. Our numbers are too small and most people use the statistics for more common lung cancer types - so no one knows.

Tom

Our cancer center currently has several trials enrolling for first-line (chemotherapy-naive) anti-PD1 or anti-PD-L1. Here is two examples:

http://www.clinicaltrials.gov/ct2/show/study/NCT01846416

http://www.clinicaltrials.gov/ct2/show/NCT01693562

One may need to check with sponsor about the histology eligibility. There are also other phase I combination trials that may be applicable. Hope this helps.

That's great news, Dr Creelan. I wish they had had one local to me back last March.