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

Takayuki Shiroyama; Shingo Nasu; Ayako Tanaka; So Takata; Kentaro Masuhiro; Hiromune Takada; Satomu Morita; Naoko Morishita; Hidekazu Suzuki; Norio Okamoto; Kunimitsu Kawahara; Tomonori Hirashima

Respiratory Medicine Case Reports (Jan 2018)

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

Takayuki Shiroyama,
Shingo Nasu,
Ayako Tanaka,
So Takata,
Kentaro Masuhiro,
Hiromune Takada,
Satomu Morita,
Naoko Morishita,
Hidekazu Suzuki,
Norio Okamoto,
Kunimitsu Kawahara,
Tomonori Hirashima

Affiliations

Takayuki Shiroyama: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan; Corresponding author. Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino City, Osaka, 583-8588, Japan.
Shingo Nasu: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Ayako Tanaka: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
So Takata: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Kentaro Masuhiro: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Hiromune Takada: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Satomu Morita: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Naoko Morishita: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Hidekazu Suzuki: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Norio Okamoto: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
Kunimitsu Kawahara: Department of Pathology, Osaka Habikino Medical Center, Osaka, Japan
Tomonori Hirashima: Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan

Journal volume & issue: Vol. 23
pp. 188 – 190

Abstract

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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. Keywords: Transformation, Small cell lung cancer, Adenocarcinoma, Rebiopsy, Acquired resistance, Afatinib

Published in Respiratory Medicine Case Reports

ISSN: 2213-0071 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: http://www.journals.elsevier.com/respiratory-medicine-case-reports/

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