Transformation to small-cell lung cancer following treatment with EGFR tyrosine kinase inhibitors in a patient with lung adenocarcinoma

Lung Cancer. 2013 Nov;82(2):370-2. doi: 10.1016/j.lungcan.2013.06.003. Epub 2013 Sep 5.

Abstract

We report the case of a 52-year-old woman with lung adenocarcinoma treated with EGFR tyrosine kinase inhibitor (TKI) therapy. After disease progression, histological examination of a secondary biopsy specimen revealed small-cell lung cancer (SCLC) that was sensitive to standard SCLC treatment. Tumor markers, including ProGRP and NSE, were elevated. Transformation to SCLC is a mechanism for acquired resistance to EGFR-TKI therapy. Secondary biopsy is important for evaluation of genetic and histological changes and selection of appropriate treatment. Furthermore, ProGRP and NSE may be useful for early detection of SCLC transformation in cases resistant to EGFR-TKI therapy.

Keywords: Adenocarcinoma; EGFR tyrosine kinase inhibitors; NSE; ProGRP; Resistance; Small cell lung cancer; Transformation.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / metabolism
  • Adenocarcinoma / pathology*
  • Adenocarcinoma of Lung
  • Biomarkers / metabolism
  • Biopsy
  • ErbB Receptors / antagonists & inhibitors
  • Female
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / pathology*
  • Middle Aged
  • Neoplasms, Second Primary*
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Small Cell Lung Carcinoma / drug therapy
  • Small Cell Lung Carcinoma / metabolism
  • Small Cell Lung Carcinoma / pathology*
  • Treatment Outcome

Substances

  • Biomarkers
  • Protein Kinase Inhibitors
  • ErbB Receptors