# Case Report: Prognostic evaluation of immunotherapy in two patients with SMARCA4-UT using TCR as a new marker

## TL;DR

This case report explores using T-cell receptor sequencing as a new marker to evaluate immunotherapy prognosis in rare SMARCA4-deficient lung cancer patients.

## Contribution

Proposes TCR as a novel prognostic marker for immunotherapy in SMARCA4-UT patients.

## Key findings

- TCR sequencing was used to monitor immune responses in two SMARCA4-UT patients undergoing immunotherapy.
- Findings suggest TCR could serve as a potential indicator for immunotherapy prognosis in these patients.
- The study provides insights into the immune microenvironment's role in treatment outcomes.

## Abstract

Thoracic SMARCA4-deficient undifferentiated tumour(SMARCA4-UT) is a newly classified subgroup of non-small cell lung cancer (NSCLC) that is rare and associated with a poor prognosis. There is a paucity of robust research regarding its treatment options and prognostic assessment. Generally, the first-line treatments for NSCLC patients with SMARCA4 are similar to those for soft tissue sarcoma (STS). STS is partially insensitive to chemotherapy and lacks specific targeted therapeutic interventions. Consequently, the immunotherapy is increasingly applied as the first-line treatment. This paper described the treatment process of two SMARCA4 patients receiving a combination of chemotherapy and immunotherapy, employing T-cell Receptor-sequencing technology(TCR). From the perspective of the immune microenvironment, we propose a novel potential marker—TCR—that may serve as an indicator for prognostic evaluation of immunotherapy in SMARCA4 patients, thereby providing a theoretical foundation from the perspectives of tissue and peripheral immunity.