Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapy
Abstract Background Non-small cell lung cancer (NSCLC) transforming to small cell lung cancer (SCLC) is one of the mechanisms of resistance to tyrosine kinase inhibitors (TKIs). Cases of NSCLC transforming into SCLC have been discovered. However, we lack concentrated data on the characteristics of t...
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| Language: | English |
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BMC
2025-02-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03687-4 |
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| author | Shuai Wang Yongsen Wang Xuan Wu Li Yang Xiaoju Zhang |
| author_facet | Shuai Wang Yongsen Wang Xuan Wu Li Yang Xiaoju Zhang |
| author_sort | Shuai Wang |
| collection | DOAJ |
| description | Abstract Background Non-small cell lung cancer (NSCLC) transforming to small cell lung cancer (SCLC) is one of the mechanisms of resistance to tyrosine kinase inhibitors (TKIs). Cases of NSCLC transforming into SCLC have been discovered. However, we lack concentrated data on the characteristics of this population and the transformed SCLC to aid our insight of the biology and clinical value of NSCLC transforming with positive. Methods We systematically reviewed the published literatures and summarized the pathological and clinical characteristics, and the prognosis, of published cases. Results 140 patients with lung adenocarcinoma (LUAD) were included in this study, with a median age of 56.8 years. The median time from the first diagnosis of LUAD transforming to SCLC (ttSCLC) was 20.0 months. The median overall survival (mOS) after the diagnosis of SCLC was 11.0 months (95% CI, 7.41 to 14.59 months). In the univariate analysis, ever smoking (either former or current) was a promising predictor of a shorter ttSCLC (HR, 1.73; 95% CI, 1.14 to 2.62; P = 0.010). TKIs therapy administered as a second line and beyond treatment was related to a significant delay in SCLC onset compared to first-line therapy (HR, 0.62; 95% CI, 0.40 to 0.96; P = 0.031). The median progression-free survival (mPFS) on first-line platinum plus etoposide after the conversion to SCLC was 3.0 months. Female appeared to be related to worse outcomes after transformation of SCLC. Conclusion Transformed SCLC exhibited poor response to primary SCLC classic chemotherapy and immunotherapy. It carries a worse prognosis. Exploring novel therapeutic strategies for transformed SCLC is imperative. |
| format | Article |
| id | doaj-art-85a65007a8734b9ea53a9d1555c74499 |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-85a65007a8734b9ea53a9d1555c744992025-02-02T12:27:33ZengBMCWorld Journal of Surgical Oncology1477-78192025-02-0123111210.1186/s12957-025-03687-4Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapyShuai Wang0Yongsen Wang1Xuan Wu2Li Yang3Xiaoju Zhang4Department of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s HospitalDepartment of Molecular Pathology, Cancer Hospital of Zhengzhou University, Henan Cancer HospitalDepartment of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s HospitalDepartment of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s HospitalDepartment of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s HospitalAbstract Background Non-small cell lung cancer (NSCLC) transforming to small cell lung cancer (SCLC) is one of the mechanisms of resistance to tyrosine kinase inhibitors (TKIs). Cases of NSCLC transforming into SCLC have been discovered. However, we lack concentrated data on the characteristics of this population and the transformed SCLC to aid our insight of the biology and clinical value of NSCLC transforming with positive. Methods We systematically reviewed the published literatures and summarized the pathological and clinical characteristics, and the prognosis, of published cases. Results 140 patients with lung adenocarcinoma (LUAD) were included in this study, with a median age of 56.8 years. The median time from the first diagnosis of LUAD transforming to SCLC (ttSCLC) was 20.0 months. The median overall survival (mOS) after the diagnosis of SCLC was 11.0 months (95% CI, 7.41 to 14.59 months). In the univariate analysis, ever smoking (either former or current) was a promising predictor of a shorter ttSCLC (HR, 1.73; 95% CI, 1.14 to 2.62; P = 0.010). TKIs therapy administered as a second line and beyond treatment was related to a significant delay in SCLC onset compared to first-line therapy (HR, 0.62; 95% CI, 0.40 to 0.96; P = 0.031). The median progression-free survival (mPFS) on first-line platinum plus etoposide after the conversion to SCLC was 3.0 months. Female appeared to be related to worse outcomes after transformation of SCLC. Conclusion Transformed SCLC exhibited poor response to primary SCLC classic chemotherapy and immunotherapy. It carries a worse prognosis. Exploring novel therapeutic strategies for transformed SCLC is imperative.https://doi.org/10.1186/s12957-025-03687-4Non-small cell lung cancerTransformationSmall cell lung cancerTKIsResistance |
| spellingShingle | Shuai Wang Yongsen Wang Xuan Wu Li Yang Xiaoju Zhang Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapy World Journal of Surgical Oncology Non-small cell lung cancer Transformation Small cell lung cancer TKIs Resistance |
| title | Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapy |
| title_full | Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapy |
| title_fullStr | Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapy |
| title_full_unstemmed | Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapy |
| title_short | Patients outcomes in lung adenocarcinoma transforming to small-cell lung cancer after tyrosine kinase inhibitor therapy |
| title_sort | patients outcomes in lung adenocarcinoma transforming to small cell lung cancer after tyrosine kinase inhibitor therapy |
| topic | Non-small cell lung cancer Transformation Small cell lung cancer TKIs Resistance |
| url | https://doi.org/10.1186/s12957-025-03687-4 |
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