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Basaloid squamous cell carcinoma is a variant of squamous lung cancer made of small, dark, tightly packed cells that grow in nests; it has a worse outlook than ordinary squamous cell carcinoma. It is treated the same way, and its high PD-L1 levels suggest immunotherapy should work, though no trial has tested it separately.
The WHO classification lists basaloid carcinoma as a form of squamous cell carcinoma (a pure form and a mixed variant with more than 50 percent basaloid pattern), having moved it out of large cell carcinoma in 2015 once immunohistochemistry showed squamous lineage in every case (Travis 2015; Pelosi 2014). Copy-number and expression profiling of 93 squamous cell carcinomas, 42 of them basaloid, showed that pure basaloid tumours have a specific expression profile, with cell-cycle, transcription, chromatin and splicing genes up and squamous differentiation genes down, from which a two-gene (SOX4, IVL) immunohistochemistry predictor separated basaloid from non-basaloid tumours with 94 percent accuracy (Brambilla 2014). In 56 resected basaloid carcinomas PD-L1 expression correlated with CD8-positive and PD-1-positive infiltrating T cells, with fair to poor agreement between some antibody clones (Modern Pathology 2016).
How it differs from its parent: the source series describes its prognosis as dismal compared with other squamous cell carcinoma, and its molecular profile is distinct; but no therapy has been shown to work better in it (Brambilla 2014).
How common: no incidence figure is published; it is a minority of squamous cell carcinomas.
Treatment: as squamous cell carcinoma of the lung by stage, including chemotherapy with pembrolizumab in metastatic disease; there is no trial in the variant.
A minority of squamous cell carcinomas: 42 of 93 in the defining molecular series were basaloid (24 pure, 18 mixed), but that series was enriched for the type (Brambilla 2014). No registry share was found in the sources read.
Central tumours arise in the large airways, peripheral ones in the alveoli; both drain to hilar then mediastinal nodes, and the pleural lining is a separate cancer site.
Same organ: Mediastinal germ cell tumour, Pleuropulmonary blastoma (types I, Ir, II and III), Type A and type AB thymoma, Type B1 and type B2 thymoma, Type B3 thymoma, Micronodular thymoma with lymphoid stroma, Adenocarcinoma of the lung, Squamous cell carcinoma of the lung, Large cell carcinoma of the lung, Sarcomatoid carcinoma of the lung, Adenosquamous carcinoma of the lung, Invasive mucinous adenocarcinoma of the lung, Adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung, Lymphoepithelial carcinoma of the lung, Pulmonary blastoma (adult), Non-small-cell lung cancer, Lung cancer (all types), Small-cell lung cancer, Mesothelioma, Pleural mesothelioma, Thymoma and thymic carcinoma, Childhood lung and airway tumours (pleuropulmonary blastoma, tracheobronchial tumours), Inflammatory myofibroblastic tumour (IMT), EGFR-mutated non-small-cell lung cancer, ALK-positive non-small-cell lung cancer, KRAS G12C-mutant non-small-cell lung cancer, ROS1-positive non-small-cell lung cancer, MET exon 14 and MET-amplified non-small-cell lung cancer, RET fusion-positive non-small-cell lung cancer, BRAF V600E-mutant non-small-cell lung cancer, HER2-mutant non-small-cell lung cancer, NTRK fusion-positive non-small-cell lung cancer, PD-L1-high non-small-cell lung cancer without a driver mutation, Resectable stage I to III non-small-cell lung cancer, Unresectable stage III non-small-cell lung cancer, Limited-stage small-cell lung cancer, Extensive-stage small-cell lung cancer, Lung neuroendocrine tumours (typical and atypical carcinoid), Thymoma (WHO types A, AB, B1, B2 and B3), Thymic carcinoma
Treated as squamous cell carcinoma of the lung; no trial in the variant.
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Query for this cancer: (TITLE:"Basaloid squamous cell carcinoma of the lung" OR ABSTRACT:"Basaloid squamous cell carcinoma of the lung" OR TITLE:"Basaloid squamous cell lung carcinoma" OR ABSTRACT:"Basaloid squamous cell lung carcinoma" OR TITLE:"Basaloid carcinoma of the lung" OR ABSTRACT:"Basaloid carcinoma of the lung" OR TITLE:"Basaloid squamous cell carcinoma" OR ABSTRACT:"Basaloid squamous cell carcinoma" OR TITLE:"Basaloid variant of squamous cell carcinoma" OR ABSTRACT:"Basaloid variant of squamous cell carcinoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Basaloid squamous cell carcinoma of the lung, not a curated reading list.
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Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
Immunotherapy can attack hormone-producing glands: most often the thyroid (usually ending in an under-active thyroid needing lifelong tablets), and less often the pituitary (hypophysitis) or adrenal glands, which can be life-threatening if missed.
See all on the product pages:Pembrolizumab·Printable cards in the navigator
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