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Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment

INTRODUCTION: SCLC is an aggressive malignancy with poor outcome. Most patients have disease recurrence despite treatments with multiple modalities. Subtyping of SCLC has been proposed recently, and novel agents targeting specific subtypes are actively being investigated. In this study, we evaluated...

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Autores principales: Lo, Ying-Chun, Rivera-Concepcion, Joel, Vasmatzis, George, Aubry, Marie-Christine, Leventakos, Konstantinos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10507151/
https://www.ncbi.nlm.nih.gov/pubmed/37731627
http://dx.doi.org/10.1016/j.jtocrr.2023.100561
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author Lo, Ying-Chun
Rivera-Concepcion, Joel
Vasmatzis, George
Aubry, Marie-Christine
Leventakos, Konstantinos
author_facet Lo, Ying-Chun
Rivera-Concepcion, Joel
Vasmatzis, George
Aubry, Marie-Christine
Leventakos, Konstantinos
author_sort Lo, Ying-Chun
collection PubMed
description INTRODUCTION: SCLC is an aggressive malignancy with poor outcome. Most patients have disease recurrence despite treatments with multiple modalities. Subtyping of SCLC has been proposed recently, and novel agents targeting specific subtypes are actively being investigated. In this study, we evaluated the plasticity of subtypes in paired pre- and post-treatment samples. The aim was to understand possible subtype evolution after chemotherapy resistance that could lead to alternate targeted therapy strategies. METHODS: A total of 68 samples from 32 patients with sufficient paired specimens were identified from 1998 to 2022. ASCL1, NEUROD1, and POU2F3 immunohistochemistry studies were performed on all cases, and subtyping by predominant expression was determined. Subtype comparison in each patient was performed, and expression analysis was performed on the basis of subtypes. RESULTS: Of 32 cases, 28 (88%) had the same subtype in pre- and first post-treatment specimens. Protein expression level of subtype-specific transcription factor remained stable after chemotherapy. Two of five (40%) NEUROD1-predominant SCLC switched to ASCL1-predominant phenotype after treatment. One case had a pitfall of scoring ASCL1 on specimen with marked crushing artifacts. One case revealed the challenge of proper subtyping for samples with borderline POU2F3 expression. CONCLUSIONS: Subtype of SCLC generally remains the same after acquiring chemotherapy resistance. Plasticity was observed with rare cases switching from NEUROD1-predominant to ASC1-predominant SCLC. Resubtyping is unnecessary for the consideration of novel subtype-specific targeted agents, except cases with NEUROD1-predominant subtype.
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spelling pubmed-105071512023-09-20 Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment Lo, Ying-Chun Rivera-Concepcion, Joel Vasmatzis, George Aubry, Marie-Christine Leventakos, Konstantinos JTO Clin Res Rep Original Article INTRODUCTION: SCLC is an aggressive malignancy with poor outcome. Most patients have disease recurrence despite treatments with multiple modalities. Subtyping of SCLC has been proposed recently, and novel agents targeting specific subtypes are actively being investigated. In this study, we evaluated the plasticity of subtypes in paired pre- and post-treatment samples. The aim was to understand possible subtype evolution after chemotherapy resistance that could lead to alternate targeted therapy strategies. METHODS: A total of 68 samples from 32 patients with sufficient paired specimens were identified from 1998 to 2022. ASCL1, NEUROD1, and POU2F3 immunohistochemistry studies were performed on all cases, and subtyping by predominant expression was determined. Subtype comparison in each patient was performed, and expression analysis was performed on the basis of subtypes. RESULTS: Of 32 cases, 28 (88%) had the same subtype in pre- and first post-treatment specimens. Protein expression level of subtype-specific transcription factor remained stable after chemotherapy. Two of five (40%) NEUROD1-predominant SCLC switched to ASCL1-predominant phenotype after treatment. One case had a pitfall of scoring ASCL1 on specimen with marked crushing artifacts. One case revealed the challenge of proper subtyping for samples with borderline POU2F3 expression. CONCLUSIONS: Subtype of SCLC generally remains the same after acquiring chemotherapy resistance. Plasticity was observed with rare cases switching from NEUROD1-predominant to ASC1-predominant SCLC. Resubtyping is unnecessary for the consideration of novel subtype-specific targeted agents, except cases with NEUROD1-predominant subtype. Elsevier 2023-08-16 /pmc/articles/PMC10507151/ /pubmed/37731627 http://dx.doi.org/10.1016/j.jtocrr.2023.100561 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Lo, Ying-Chun
Rivera-Concepcion, Joel
Vasmatzis, George
Aubry, Marie-Christine
Leventakos, Konstantinos
Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment
title Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment
title_full Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment
title_fullStr Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment
title_full_unstemmed Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment
title_short Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment
title_sort subtype of sclc is an intrinsic and persistent feature through systemic treatment
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10507151/
https://www.ncbi.nlm.nih.gov/pubmed/37731627
http://dx.doi.org/10.1016/j.jtocrr.2023.100561
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