Two Cases of TKI-resistant Small Cell Lung Cancer Transformation
in Advanced Adenocarcinoma and Literature Review.
10.3779/j.issn.1009-3419.2022.102.41
- Author:
Jieqiong WU
1
;
Dunqiang REN
1
;
Bingqian YI
1
;
Huanhuan BI
2
;
Yanmei SHAO
1
;
Hongmei WANG
1
Author Information
1. Department of Respiratory and Critical Care Medcine, The Affiliated Hospital of Qingdao University.
2. School of Medicine, Qingdao University, Qingdao 266000, China.
- Publication Type:Journal Article
- Keywords:
EGFR gene mutation;
RB1;
Small cell carcinoma transformation;
TP53
- MeSH:
Humans;
Carcinoma, Small Cell;
Carcinoma, Non-Small-Cell Lung/genetics*;
Lung Neoplasms/genetics*;
Adenocarcinoma/genetics*;
Small Cell Lung Carcinoma/genetics*;
ErbB Receptors/genetics*
- From:
Chinese Journal of Lung Cancer
2022;25(11):828-834
- CountryChina
- Language:Chinese
-
Abstract:
Treatment of advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can achieve good disease control, but it will inevitably produce drug resistance. About 3%-10% of the resistance mechanism is small cell transformation. Two cases of stage IV lung adenocarcinoma with EGFR mutation were reported and the disease was controlled after EGFR-TKIs treatment. In case 1, progression-free survival (PFS) before small cell carcinoma transformation was 16 months, and in case 2, PFS before small cell carcinoma transformation was 24 months. Subsequent biopsy after disease progression indicated a shift to small cell lung cancer. Case 1 PFS after small cell carcinoma transformation was 6 months, and case 2 PFS after small cell carcinoma transformation was 8 months, and overall survival (OS) was 36 months, which significantly prolonged the patient's survival. At the same time, the literature of such drug resistance mutations was reviewed. For patients with advanced NSCLC with sensitive mutations, it is necessary to conduct secondary histopathological tests after TKIs treatment resistance, and select subsequent treatment according to different resistance mechanisms for the whole course of disease management.
.
