EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures review
Advances in molecular biology have positioned epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) as highly effective therapies for patients with EGFR-mutant carcinomas. However, the inevitable emergence of acquired resistance significantly limits their long-term efficacy. Among...
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| Language: | English |
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Elsevier
2025-01-01
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| Series: | Respiratory Medicine Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007125000553 |
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| author | Jinhong Chen Hongxiang Huang Peiyuan Zhong Sujuan Peng Xie Zhu Xinjing Ding Fen Wang Ping Kong Tiantian Song Zhihui Lu Li Chen |
| author_facet | Jinhong Chen Hongxiang Huang Peiyuan Zhong Sujuan Peng Xie Zhu Xinjing Ding Fen Wang Ping Kong Tiantian Song Zhihui Lu Li Chen |
| author_sort | Jinhong Chen |
| collection | DOAJ |
| description | Advances in molecular biology have positioned epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) as highly effective therapies for patients with EGFR-mutant carcinomas. However, the inevitable emergence of acquired resistance significantly limits their long-term efficacy. Among resistance mechanisms, the transformation of lung adenocarcinoma to small cell lung cancer (SCLC) following EGFR-TKIs therapy is an uncommon but clinically important phenomenon contributing to treatment failure.We present a case of SCLC transformation in a patient with EGFR-mutant lung adenocarcinoma after 8 months of first-line osimertinib therapy. Following 4 cycles of etoposide combined with lobaplatin chemotherapy, adenocarcinoma cells regained predominance, illustrating a dynamic histological shift between adenocarcinoma and SCLC phenotypes. Subsequent treatment with 2 cycles of chemotherapy plus osimertinib resulted in disease stabilization. However, multiple brain metastases were identified 3 months after completing 6 cycles of chemotherapy.This case underscores the bidirectional histological plasticity between lung adenocarcinoma and SCLC during treatment and highlights the critical importance of repeated biopsies for guiding management strategies in the context of resistance. We also provide a comprehensive review of the clinical manifestations, underlying mechanisms, predictive biomarkers, and therapeutic approaches for SCLC transformation. |
| format | Article |
| id | doaj-art-e84b9f8876de4e0780e98c27aee34197 |
| institution | Kabale University |
| issn | 2213-0071 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj-art-e84b9f8876de4e0780e98c27aee341972025-08-20T03:48:47ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015510221910.1016/j.rmcr.2025.102219EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures reviewJinhong Chen0Hongxiang Huang1Peiyuan Zhong2Sujuan Peng3Xie Zhu4Xinjing Ding5Fen Wang6Ping Kong7Tiantian Song8Zhihui Lu9Li Chen10Department of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China; Department of Oncology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China; Department of Oncology, Huizhou Central People's Hospital, Huizhou, 516001, Guangdong, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China; Department of Oncology, Heyuan People's Hospital, Heyuan, 517000, Guangdong, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, ChinaDepartment of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China; Corresponding author.Department of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China; Corresponding author.Advances in molecular biology have positioned epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) as highly effective therapies for patients with EGFR-mutant carcinomas. However, the inevitable emergence of acquired resistance significantly limits their long-term efficacy. Among resistance mechanisms, the transformation of lung adenocarcinoma to small cell lung cancer (SCLC) following EGFR-TKIs therapy is an uncommon but clinically important phenomenon contributing to treatment failure.We present a case of SCLC transformation in a patient with EGFR-mutant lung adenocarcinoma after 8 months of first-line osimertinib therapy. Following 4 cycles of etoposide combined with lobaplatin chemotherapy, adenocarcinoma cells regained predominance, illustrating a dynamic histological shift between adenocarcinoma and SCLC phenotypes. Subsequent treatment with 2 cycles of chemotherapy plus osimertinib resulted in disease stabilization. However, multiple brain metastases were identified 3 months after completing 6 cycles of chemotherapy.This case underscores the bidirectional histological plasticity between lung adenocarcinoma and SCLC during treatment and highlights the critical importance of repeated biopsies for guiding management strategies in the context of resistance. We also provide a comprehensive review of the clinical manifestations, underlying mechanisms, predictive biomarkers, and therapeutic approaches for SCLC transformation.http://www.sciencedirect.com/science/article/pii/S2213007125000553Small cell lung cancerLung adenocarcinomaTransformationEGFR mutationRepeat biopsy |
| spellingShingle | Jinhong Chen Hongxiang Huang Peiyuan Zhong Sujuan Peng Xie Zhu Xinjing Ding Fen Wang Ping Kong Tiantian Song Zhihui Lu Li Chen EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures review Respiratory Medicine Case Reports Small cell lung cancer Lung adenocarcinoma Transformation EGFR mutation Repeat biopsy |
| title | EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures review |
| title_full | EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures review |
| title_fullStr | EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures review |
| title_full_unstemmed | EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures review |
| title_short | EGFR-mutant lung adenocarcinoma transformed into small cell Lung cancer: A case report and literatures review |
| title_sort | egfr mutant lung adenocarcinoma transformed into small cell lung cancer a case report and literatures review |
| topic | Small cell lung cancer Lung adenocarcinoma Transformation EGFR mutation Repeat biopsy |
| url | http://www.sciencedirect.com/science/article/pii/S2213007125000553 |
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