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Tumor Discovery Expert consensus of NUT carcinoma

of 6 months (5-7.93). Regarding immunotherapy, patients For thoracic NUT carcinoma patients, treatment types were
who received immunotherapy treatment reached a median ranked by median survival time as follows: chemotherapy
survival time of 19.5 months (12-NA), while those without + surgery (mOS: 19 months), including immunotherapy
immunotherapy treatment had a median survival time of (mOS: 12 months), chemotherapy + radiotherapy (mOS:
7.93 months (6-10.6). 6 months), and chemotherapy (mOS: 4 months).

Although surgery and immunotherapy demonstrated Due to the limited analyzable data, we only evaluated
significant survival benefits (p<0.05) in the thoracic the first and second treatment regimens. The benefit of
NUT carcinoma group, immunotherapy had the most surgery was most pronounced regardless of whether it was
pronounced effect. In thoracic NUT carcinoma patients, the first or second treatment (sequence 1 mOS: 15 months,
those who received immunotherapy in combination sequence 2 mOS: 16.5 months).
with other therapeutic modalities achieved a median Among patients unable to undergo surgery as the first-
overall survival (mOS) of 19.5 months. For patients line treatment, the median survival times were ranked as
who did not receive immunotherapy, the median overall follows: chemotherapy (mOS: 8 months), radiotherapy
survival was 6 months. Regarding surgical intervention, (mOS: 7.46 months), and BET (mOS: 6 months). In thoracic
patients who underwent surgery demonstrated a median NUT carcinoma patients, those receiving radiotherapy
overall survival of 18.7 months (12.2 – 24.6), while those (mOS: 6.95 months) had a slightly higher median survival
who did not receive surgical treatment had a median time compared to those receiving chemotherapy (mOS:
overall survival of 10 months (8.4 – 26). In head-and- 6 months). However, this trend was reversed in head-
neck NUT carcinoma patients, those who underwent and-neck NUT carcinoma patients, where chemotherapy
surgical treatment achieved a median overall survival of [mOS: 10 months (8.4,28)] showed a better outcome than
16.5 months, while patients who did not receive surgery radiotherapy [mOS: 7.46 months (5.5,NA)]. No statistically
had a median overall survival of 7.46 months. Regarding significant differences were observed between the second-
immunotherapy, patients who received combined line treatment or after surgery.
immunotherapy demonstrated a median overall survival
of 31.4 months, whereas those who did not receive We also analyzed treatment regimens and specific
immunotherapy had a median overall survival of chemotherapy drugs for NUT carcinoma patients who
11 months. received chemotherapy exclusively. No significant statistical
difference in survival was found between ifosfamide
Patients who received combined immunotherapy
during treatment (mOS: 19.5 months [: 12, NA]) showed (IFO; mOS: 8 months) alone and platinum-containing
chemotherapy regimens without IFO (mOS: 8 months).
better survival outcomes compared to those who did not However, chemotherapy regimens containing IFO had
receive immunotherapy (mOS: 7.93 months [6,10.6]), higher OS times compared to other drugs, including
particularly among patients undergoing combined Abraxane, docetaxel, paclitaxel, cisplatin, carboplatin,
surgery and immunotherapy (mOS: 31.43 [10, NA]). doxorubicin, cyclophosphamide, and etoposide. However,
Unfortunately, our study recorded a low incidence the difference between IFO and platinum-based drugs was
of PD-L1/programmed cell death protein 1 (PD-1) not statistically significant.
positivity, making it challenging to assess the efficacy of
immunotherapy in NUT carcinoma patients with negative In thoracic NUT carcinoma patients, chemotherapy
PD-L1/PD-1 expression. Thus, validation through large- regimens containing IFO still provided slightly better
scale cohort studies is necessary. survival outcomes than other drugs. Conversely, in head-
and-neck NUT carcinoma patients, regimens including
A survival analysis was conducted on 339 patients, with
survival data categorized by treatment type. The treatments platinum-based drugs showed better outcomes than other
were ranked by median survival time as follows (Figure 2): drugs (Table S6).
include surgery + immunotherapy (mOS: 31.43 months), Finally, we conducted a separate comparison of
radiotherapy + surgery (mOS: 24 months), chemotherapy regimens containing multiple chemotherapy drugs. The
+ radiotherapy + surgery (mOS: 14 months), chemotherapy IFO+etoposide+platinum (IEP) regimen provided the best
+ surgery (mOS: 12 months), include immunotherapy survival benefits (mOS: 10 months) compared to regimens
(mOS: 12 months), chemotherapy + radiotherapy (mOS: containing only platinum (Taxanes +platinum [TP]:
7.93 months), surgery (mOS: 7 months), include BET (mOS: 8.4 months [6,16], etoposide+platinum [EP]: 7 months [4,
6 months), radiotherapy (mOS: 5.95 months), include HDAC NA]), or only IFO (IFO+etoposide: 8 months [4.5, NA]).
(mOS: 5.8 months), and chemotherapy (mOS: 4 months). However, no statistically significant difference was found

Volume 3 Issue 4 (2024) 10 doi: 10.36922/td.4904