Synchronous occurrence of squamous-cell carcinoma "transformation" and EGFR exon 20 S768I mutation as a novel mechanism of resistance in EGFR-mutated lung adenocarcinoma. (January 2017)

• Record Type: Journal Article
• Authors: Longo, Lucia; Mengoli, Maria Cecilia; Bertolini, Federica; Bettelli, Stefania; Manfredini, Samantha; Rossi, Giulio
• Is Part Of: Lung cancer. Volume 103(2017)
• Page Start: 24
• Page End: 26
• Publication Date: 2017-01
• Subjects: Lung cancer -- Adenocarcinoma -- Squamous cell carcinoma -- EGFR -- Mutation; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2016.11.012
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: The synchronous occurrence of SCC "transformation" and exon 20 S768I is described. SCC transformation and exon 20 S768I is an unreported mechanism of resistance. This situation is challenging for clinicians in the choice of a second line therapy. Abstract: The occurrence of secondary EGFR mutation T790 M in exon 20 and histologic "transformation" are common mechanisms underlying resistance to EGFR first- or second-generation tyrosine kinase inhibitors (TKI). We describe here on a hitherto unreported mechanism of EGFR TKI resistance synchronously combining squamous-cell carcinoma change and occurrence of the EGFR exon 20 S768I secondary mutation in a 43 year-old woman with stage IV adenocarcinoma harbouring EGFR exon 21 L858R mutation. After 8 months of response to gefitinib, the patient experienced EGFR TKI resistance and died of leptomeningeal neoplastic dissemination.