What experimental treatments exist for lung carcinosarcoma?

2026-09-16

Lung carcinosarcoma (pulmonary carcinosarcoma) is a rare and aggressive pulmonary neoplasm that combines carcinomatous and sarcomatous components. Currently, international clinical trial registries do not contain open clinical trials specifically dedicated to lung carcinosarcoma; patients are most frequently enrolled into broader protocols targeting advanced non-small cell lung cancer (NSCLC) or solid tumours. Based on literature case reports and observational data, the main directions for experimental and personalised systemic therapies include immunotherapy (immune checkpoint inhibitors, such as nivolumab), targeted therapy based on molecular alterations (for example, osimertinib in the presence of an EGFR mutation, tyrosine kinase inhibitors such as anlotinib, or multi-kinase inhibitors such as pazopanib), as well as newer modalities investigated in other pulmonary sarcomatoid carcinomas, such as Trop-2-targeted antibody-drug conjugates (ADCs).

Due to the rarity of lung carcinosarcoma, the majority of research evidence derives from individual case reports and small cohorts. Case studies have described the efficacy of nivolumab in PD-L1-positive metastatic disease, the combination of osimertinib with neoadjuvant chemotherapy in an EGFR-mutant tumour, and the use of pazopanib or anlotinib supplemented with stereotactic body radiation therapy. In addition, high Trop-2 expression demonstrated in pulmonary sarcomatoid carcinomas raises the potential for future investigation of anti-Trop-2 antibody-drug conjugates.

References

  1. Neoadjuvant osimertinib and chemotherapy for stage IIIA primary pulmonary carcinosarcoma with EGFR 19DEL mutation: A case report. PMID 36969031
  2. First-Line Anlotinib Combined with Stereotactic Body Radiation Therapy for an Octogenarian with Pulmonary Carcinosarcoma. PMID 35023973
  3. Pulmonary carcinosarcoma showing an obvious response to pazopanib: a case report. PMID 30541518
  4. Significant benefit of Nivolumab treating PD-L1 positive metastatic pulmonary carcinosarcoma: a case report and literature review. PMID 29221220
  5. High Trop-2 expression in pulmonary sarcomatoid carcinoma reveals antibody-drug conjugate targeting Trop-2 is a promising therapeutic approach. PMID 40739577

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