SWItch/Sucrose Nonfermentable complex-deficient pulmonary neoplasms - clinicopathologic characteristics and outcomes to radiotherapy and immunotherapy

Q: What patient cohort and tumor biomarkers were assessed in this study?

The study retrospectively analyzed 101 SWI/SNF-d pulmonary neoplasms from 675 SWI/SNF-d cancer patients, with SWI/SNF subunit expression (ARID1A, SMARCA2, SMARCA4, SMARCB1) determined by immunohistochemistry.

Q: Which factors were identified as key prognostic determinants for overall survival?

Overall survival was mainly associated with distant metastasis, radiotherapy, and immunotherapy.

Q: How did immunotherapy and radiotherapy affect 3-year overall survival rates?

Immunotherapy increased 3-year OS from 20.8% to 68.4%, while radiotherapy increased 3-year OS from 30.7% to 61.7%.

Sep 21, 2026

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SWI/SNF-d pulmonary neoplasms are associated with aggressive behavior when the chromatin remodeling complex is deficient, making accurate expression assessment essential for targeted treatment. This retrospective study analyzed 101 SWI/SNF-d pulmonary tumors from 675 SWI/SNF-d cancer patients, profiling ARID1A, SMARCA2, SMARCA4, and SMARCB1 by immunohistochemistry. Distant metastasis and receipt of radiotherapy or immunotherapy emerged as key overall survival factors. Immunotherapy and radiotherapy improved 3-year OS, and combining radiotherapy with immunotherapy showed potential synergistic benefit.

LanguageEnglish

CategoryResearch & Report

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Pages13

Reading Time33 min

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Background

Methods

Results

Key clinical and prognostic findings

Conclusions

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SWItch/Sucrose Nonfermentable complex-deficient pulmonary neoplasms: clinicopathologic characteristics and outcomes to radiotherapy and immunotherapy Yu Gu1,2,3,4\#, Songtao Lai1,2,3,4\#, Juan Yang5\#, Junhua Zhang1,2,3,4, Xingwen Fan1,2,3,4, Qiang Zheng6 1Department of Radiation Oncology, Shanghai Cancer Center, Fudan University, Shanghai, China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; 3Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China; 4Shanghai Key Laboratory of Radiation Oncology, Shanghai, China; 5Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Xiaogan, China; 6Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China Contributions: (I) Conception and design: Y Gu; (II) Administrative support: Y Gu; (III) Provision of study materials or patients: Y Gu, S Lai; (IV) Collection and assembly of data: J Yang, J Zhang, Q Zheng; (V) Data analysis and interpretation: S Lai, X Fan, J Yang; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. \#These authors contributed equally to this work as co-first authors. Correspondence to: Yu Gu, MD, PhD. Department of Radiation Oncology, Shanghai Cancer Center, Fudan University, 270 Dong’an Street, Shanghai 200000, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, [China. Email: yu_gu@fudan.edu.cn](China. Email: yu_gu@fudan.edu.cn). Background: The SWItch/Sucrose Nonfermentable (SWI/SNF) complex, a multi-subunit chromatin remodeler, is linked to aggressive tumors when deficient. Accurate identification of SWI/SNF expression status is crucial for tailoring targeted therapies. Previous studies on the efficacy of immunotherapy for SWI/ SNF-deficient (SWI/SNF-d) pulmonary tumors primarily focus on non-small cell lung cancer (NSCLC), with limited data on other modalities like radiotherapy. This study aims to analyze the clinicopathological characteristics and prognostic factors of SWI/SNF-d pulmonary neoplasms, including NSCLC and undifferentiated tumors, and to evaluate the effectiveness of radiotherapy and immunotherapy, providing a foundation for improved treatment strategies and prognostic assessments. Methods: Patient data on SWI/SNF-d pulmonary neoplasms were collected from Fudan University Shanghai Cancer Center, assessing ARID1A, SMARCA2, SMARCA4, and SMARCB1 subunit expression via immunohistochemistry, with retrospective analysis of survival and treatment results. Results: The study analyzed 101 SWI/SNF-d pulmonary neoplasms from 675 SWI/SNF-d cancer patients (January 2017 to August 2023), mostly male smokers, showing high malignancy. Clinicopathologic features were consistent across patients with various SWI/SNF subunit deficiencies. TP53 was the most common comutated gene (71%), followed by STK11, CDKN2A, KRAS, APC, and EGFR. Key prognostic factors for overall survival (OS) were distant metastasis, radiotherapy, and immunotherapy. Immunotherapy improved 3-year OS rates from 20.8% to 68.4%(P<0.001) . KRAS-mutated patients on immunotherapy showed a lower 1-year survival rate (60.0% vs. 83.1%, P=0.08) . Radiotherapy increased 3-year OS rates to 61.7% from 30.7%(P=0.012). Of 38 patients treated with immunotherapy, 16 benefited from radiotherapy [median OS: 31.4 months vs. not estimable (NE), P=0.045], with an average 17.2 days between radiotherapy and immunotherapy. Conclusions: SWI/SNF-d pulmonary neoplasms, whether with multiple or single subunit losses, exhibit similar clinicopathological characteristics. Radiotherapy and immunotherapy are effective treatments for these patients, and the combination of radiotherapy with immunotherapy may offer synergistic effects. Keywords: SWItch/Sucrose Nonfermentable complex (SWI/SNF complex); radio

FAQs

What patient cohort and tumor biomarkers were assessed in this study?

The study retrospectively analyzed 101 SWI/SNF-d pulmonary neoplasms from 675 SWI/SNF-d cancer patients, with SWI/SNF subunit expression (ARID1A, SMARCA2, SMARCA4, SMARCB1) determined by immunohistochemistry.

Which factors were identified as key prognostic determinants for overall survival?

Overall survival was mainly associated with distant metastasis, radiotherapy, and immunotherapy.

How did immunotherapy and radiotherapy affect 3-year overall survival rates?

Immunotherapy increased 3-year OS from 20.8% to 68.4%, while radiotherapy increased 3-year OS from 30.7% to 61.7%.

Sep 21, 2026

Uploaded by Skyler