Lung adenocarcinoma with malignant serous effusions: A comprehensive clinicopathologic, molecular, and outcome analysis - PubMed
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- #Lung Adenocarcinoma
- #Malignant Effusions
- #Prognostic Biomarkers
- The study retrospectively analyzed 120 cases of lung adenocarcinoma (LUAD) with malignant serous effusions (MSEs), including pleural, pericardial, and peritoneal sites, to integrate clinicopathologic, molecular, treatment, and outcome data.
- Median survival from first malignant effusion (SME) was 3.8 months, with the shortest SME in peritoneal effusions (1.0 months), and overall survival (OS) was shortest with pericardial involvement (6.1 months).
- Thyroid transcription factor 1 (TTF-1) was positive in 72.5% of cases, and PD-L1 expression (tumor proportion score ≥1%) was found in 80% of tested cases, with higher expression linked to TTF-1 positivity.
- Molecular profiling identified TP53 mutations in 42.3% of cases and actionable driver alterations (e.g., in EGFR, KRAS, BRAF, ALK, ROS1) in 42.3%, with TTF-1 positivity associated with higher rates of these alterations.
- TTF-1 negativity, PD-L1 negativity, and absence of actionable driver alterations were associated with shorter SME and OS, with dual TTF-1/PD-L1 negativity defining the poorest risk subgroup (median SME 1.2 months, OS 1.4 months).
- Multivariable analysis confirmed TTF-1 negativity and lack of actionable drivers as independent adverse prognostic factors, and immunotherapy-based regimens were linked to the longest SME (6.7 months), while tyrosine kinase inhibitor therapy had the longest OS (26.0 months).