Squamous Cell Carcinoma in Never Smokers: An Insight into SMARCB1 Loss
Abstract
:1. Introduction
2. Results
3. Discussion
4. Methods and Materials
- Any patient who had undergone radical surgical resection for squamous cell carcinoma of the lung in the time period.
- Never smoking status.
- Non-squamous histology.
Statistical Analysis
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Patient 1 | Patient 2 |
---|---|
36-year-old male. Never smoker. BMI 31.1. No significant co-morbidities. No history of cancer. | 39-year-old male. Never smoker. BMI 27.4. No significant co-morbidities. No history of cancer. |
Presented with dull left sided chest pain in September 2022. | Incidental finding of lung mass in right upper lobe after investigation for abdominal pain. |
Stage 2b NSCLC. | Stage 1B NSCLC. |
Lung resection November 2022—Left lower lobectomy + lymph node dissection: pT3pN0 R0 resection. SMARCB1-deficient, PDL1-negative, TTF-1 negative, CD56-positive, cytokeratin positive. Pre-operative CT axial and coronal slices are shown in Figure 2A and Figure 2B, respectively. | Lung resection January 2022—right upper lobectomy + lymph node dissection: pT1cpN0 R0 resection. SMARCB1-deficient, PDL1 negative, TTF-1 negative, CD56-positive, cytokeratin-positive. Pre-operative axial PET slice shown in Figure 3A. |
Histopathological Features: 58 mm size tumor, lymphovascular and perineural invasion seen, no spread through airways (STAS), no breach of visceral pleura. | Histopathological Features: 21 mm size tumor, no lymphovascular and perineural invasion seen, no spread through airways (STAS), no breach of visceral pleura. |
Recurrence December 2022—started 4 cycles of Gemcitabine/Cisplatin. Post-operative recurrence demonstrated in PET slices (Figure 2C,D) | Recurrence June 2022—progressive disease noted on CTPA (performed for SOB, pyrexia) at the right hilum, with soft tissue thickening at resection margins. Commenced on Pembrolizumab/Paclitaxel/Cisplatin with systemic intent. Recurrence shown in station 4R (Figure 3B), at the right hilum (Figure 3C) and in the right posterior bony skeleton in ribs 6–9 (Figure 3D). |
Progressive disease in pleura and mediastinum April 2023—compassionate release form to administer Tazemetostat. | Chemotherapy stopped due to severe allergic reaction to drugs—November 2022. Resolution of soft tissue thickening on PET but with new pleural metastases and bulky paraoesophageal lymphadenopathy. Further maintenance Pembrolizumab only. |
Increased burden of disease in left hemithorax August 2023—compassionate release of combination checkpoint blockade: Nivolumab/Ipilimumab, Tazemetostat stopped. | Slight progression on CT January 2023. Patient opted for surgical resection of metastatic sites abroad. |
November 2023—three cycles of checkpoint blockade but developed severe rib pain due to a medial 4th destroying lesion (pure progressive disease), given 20 Gy in 5# of palliative radiotherapy. | Further lung resection March 2023—multiple wedge resections of RUL and RML. Radical lymphadenectomy and resection of tumor deposits in the chest wall, pericardium, and mediastinum and sheath of the SVC. |
December 2023—all treatment stopped in light of progression and episode of viral pneumonia. Referred to hospice for palliation. | Patient currently under strict surveillance and has relocated abroad. |
February 2024—Under palliative care team with good symptom control. |
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Patel, A.J.; Hemead, H.; Jesani, H.; Bille, A.; Taniere, P.; Middleton, G. Squamous Cell Carcinoma in Never Smokers: An Insight into SMARCB1 Loss. Int. J. Mol. Sci. 2024, 25, 8165. https://doi.org/10.3390/ijms25158165
Patel AJ, Hemead H, Jesani H, Bille A, Taniere P, Middleton G. Squamous Cell Carcinoma in Never Smokers: An Insight into SMARCB1 Loss. International Journal of Molecular Sciences. 2024; 25(15):8165. https://doi.org/10.3390/ijms25158165
Chicago/Turabian StylePatel, Akshay J., Hanan Hemead, Hannah Jesani, Andrea Bille, Philippe Taniere, and Gary Middleton. 2024. "Squamous Cell Carcinoma in Never Smokers: An Insight into SMARCB1 Loss" International Journal of Molecular Sciences 25, no. 15: 8165. https://doi.org/10.3390/ijms25158165