Successful sequential treatment of refractory tumors caused by small cell carcinoma transformation and EGFR-T790M mutation diagnosed by repeated genetic testing in a patient with lung adenocarcinoma harboring epidermal growth factor receptor mutations: A case report

Naoya Nishioka; Tadaaki Yamada; Sachi Harita; Soichi Hirai; Yuki Katayama; Takayuki Nakano; Naoko Okura; Nobuyo Tamiya; Yoshiko Kaneko; Junji Uchino; Koichi Takayama

doi:10.1016/j.rmcr.2018.10.004

Successful sequential treatment of refractory tumors caused by small cell carcinoma transformation and EGFR-T790M mutation diagnosed by repeated genetic testing in a patient with lung adenocarcinoma harboring epidermal growth factor receptor mutations: A case report

Respir Med Case Rep. 2018 Oct 6:25:261-263. doi: 10.1016/j.rmcr.2018.10.004. eCollection 2018.

Authors

Affiliation

¹ Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan.

Abstract

NSCLC patients with EGFR mutations respond to EGFR-TKIs; however, the management of refractory tumors to EGFR-TKIs remains unclear. We demonstrated that repeated genetic testing might be useful for detecting resistance mechanisms as well as for decision-making in EGFR mutated NSCLC patients, following the emergence of resistance to the initial EGFR-TKIs. A 69-year-old man was diagnosed with lung adenocarcinoma with an EGFR exon 19 deletion. After tumor re-growth treated with erlotinib and chemotherapy, he was diagnosed with an SCLC transformation and administered chemotherapy to treat the SCLC. After the resistance of chemotherapy, the EGFR-T790M mutation by liquid biopsy was detected and treated him with osimertinib, which resulted in a clinical response.

Keywords: Drug resistance; EGFR-T790M; Liquid biopsy; Repeated genetic testing; SCLC transformation.

Publication types

Case Reports