Transformation to small cell lung cancer after first-line afatinib treatment

Acquiring resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) is inevitable. Transformation to small cell lung cancer (SCLC) is reported as a possible mechanism of this acquired resistance. We describe the case of a 35-year-old man with lung adenocarcinoma harbori...

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Detalles Bibliográficos
Autores principales: Shiroyama, Takayuki, Nasu, Shingo, Tanaka, Ayako, Takata, So, Masuhiro, Kentaro, Takada, Hiromune, Morita, Satomu, Morishita, Naoko, Suzuki, Hidekazu, Okamoto, Norio, Kawahara, Kunimitsu, Hirashima, Tomonori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925950/
https://www.ncbi.nlm.nih.gov/pubmed/29719814
http://dx.doi.org/10.1016/j.rmcr.2018.02.011
Descripción
Sumario:Acquiring resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) is inevitable. Transformation to small cell lung cancer (SCLC) is reported as a possible mechanism of this acquired resistance. We describe the case of a 35-year-old man with lung adenocarcinoma harboring EGFR exon 19 deletion. After 7 months of successful treatment with afatinib, he experienced relapse and rebiopsy revealed SCLC with EGFR exon 19 deletion. Tumor marker tests at this point showed normal levels of serum neuron-specific enolase and pro-gastrin releasing peptide. Our case highlights the importance of rebiopsy for revealing SCLC transformation, a potential mechanism of acquired resistance to afatinib as with other EGFR-TKIs, and normal-range values of tumor markers for SCLC cannot exclude the possibility of SCLC transformation.

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