Squamous cell histological transformation in a lung adenocarcinoma patient (hyper) progressing upon immunotherapy. Issue 6 (December 2022)

• Record Type: Journal Article
• Authors: Mariniello, Annapaola; Righi, Luisella; Morrone, Antonio; Carnio, Simona; Bironzo, Paolo
• Is Part Of: Tumori. Volume 108:Issue 6(2022)
• Page Start: NP15
• Page End: NP19
• Publication Date: 2022-12
• Subjects: Lung cancer -- immunotherapy -- histological transformation -- disease hyperprogression; Cancer -- Periodicals; 616.994
• DOI: 10.1177/03008916221080487
• Languages: English
• ISSNs: 0300-8916

Abstract

Introduction: In non-small cell lung cancer (NSCLC) histologic transformation upon immune checkpoint inhibitors (ICI) is rare. Case presentation: We described the case of a patient with early-stage lung adenocarcinoma who relapsed after surgery. At the time of relapse, he received chemo-radiotherapy, followed by consolidation immunotherapy. After 3 cycles the patient experienced disease hyperprogression for onset of a new lung mass, which resulted in squamous cell carcinoma. The preservation of an atypical mutation in the v-raf murine sarcoma viral oncogene homolog B1 (BRAF) gene in both the primary adenocarcinoma and the new squamous carcinoma suggests histological transformation, likely ICI-related. Discussion: We reviewed similar cases in literature, highlighting common patterns and substantial differences. For a deeper insight into inherent biological mechanisms, re-biopsy in case of atypical ICI response should be encouraged.