EGFR T790M mutation after chemotherapy for small cell lung cancer transformation of EGFR-positive non-small cell lung cancer. (2018)

• Record Type: Journal Article
• Authors: Sonoda, Tomoaki; Nishikawa, Shingo; Sakakibara, Rie; Saiki, Masafumi; Ariyasu, Ryo; Koyama, Junji; Kitazono, Satoru; Yanagitani, Noriko; Horiike, Atsushi; Ohyanagi, Fumiyoshi; Ninomiya, Hironori; Ishikawa, Yuichi; Nishio, Makoto
• Is Part Of: Respiratory medicine case reports. Volume 24(2018)
• Page Start: 19
• Page End: 21
• Publication Date: 2018
• Subjects: NSCLC -- EGFR mutation -- SCLC transformation -- T790M -- Osimertinib; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2018.03.009
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: In non-small cell lung cancer (NSCLC) with an epidermal growth factor receptor (EGFR) mutation, 50%–65% of cases acquire resistance after treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) because of an EGFR T790M point mutation and 3%–14% of these cases transformed to small cell lung cancer (SCLC). Generally, the EGFR T790M secondary mutation develops with ongoing ATP competitive inhibition. We present a case of a 76-year-old woman with lung adenocarcinoma harboring an EGFR-L858R mutation who received first-line gefitinib and developed SCLC transformation. She was administered several chemotherapy agents, including a platinum doublet. The primary lesion that showed SCLC transformation had reconverted to adenocarcinoma with EGFR L858R and T790M mutations at the time of a second re-biopsy. Therefore, she was administered osimertinib, which resulted in clinical remission. This case suggested that serial biopsies are necessary even after SCLC transformation.