Integrated molecular and clinical characterization of pulmonary large cell neuroendocrine carcinoma
Nature communications · Aug 2025 · cohort study (two independent clinical/genomic cohorts)
The authors analyzed clinical and molecular data from 590 patients with pulmonary large cell neuroendocrine carcinoma across two cohorts. They identified two genomic subtypes (NSCLC-like with KEAP1/KRAS/STK11 mutations and SCLC-like with RB1/TP53 mutations) and report that 80% of tumors aligned with SCLC transcriptional profiles. The study found elevated FGL-1 and SPINK1 expression in NSCLC-like LCNECs and higher DLL3 in SCLC-like LCNECs, and noted fewer tumor-infiltrating lymphocytes in LCNEC compared with other lung cancers. Overall survival was comparable across chemotherapy, chemoimmunotherapy, and immunotherapy in this cohort.
Reported effect: proportion aligning with SCLC transcriptional profiles 80%, n=590
Key findings
- Study cohort: 590 patients across two independent cohorts.
- Comparable overall survival across treatment regimens (chemotherapy, chemoimmunotherapy, immunotherapy) without unexpected adverse events.
- Genomic analysis identified two LCNEC subtypes: NSCLC-like (KEAP1, KRAS, STK11 mutations) and SCLC-like (RB1, TP53 mutations).
- 80% of LCNEC tumors aligned with SCLC transcriptional profiles.
- Serial sampling showed stable mutational landscapes but shifting transcriptomic profiles over time.
- Elevated FGL-1 (a LAG-3 ligand) and SPINK1 expression were observed in NSCLC-like LCNECs; DLL3 levels were higher in SCLC-like LCNECs.
- Immunofluorescence confirmed FGL-1 expression in NSCLC-like LCNECs.
- H&E analyses indicated fewer tumor-infiltrating lymphocytes in LCNECs versus other lung cancers.
- Authors suggest these immunogenomic features support future investigation of LAG-3, SPINK1, and DLL3-targeted approaches.
Identifies immunogenomic subtypes and candidate targets (FGL-1/LAG-3, SPINK1, DLL3) in LCNEC that may guide future therapeutic investigations.
AI summary of the abstract, human-reviewed · Jun 2026. Describes what this study reported, not medical advice. View on PubMed · Full text