Transformation to small-cell carcinoma as an acquired resistance mechanism to AZD9291: A case report

被引:51
作者
Li, Lin [1 ]
Wang, Hui [1 ]
Li, Chao [1 ]
Wang, Zheng [2 ]
Zhang, Ping [1 ]
Yan, Xu [1 ]
机构
[1] Natl Ctr Gerontol, Beijing Hosp, Dept Oncol, Beijing, Peoples R China
[2] Natl Ctr Gerontol, Beijing Hosp, Dept Pathol, Beijing, Peoples R China
关键词
NSCLC; EGFR-TKI; AZD9291; acquired resistance; transformation; LUNG-CANCER; EGFR-INHIBITOR; ADENOCARCINOMA; PATIENT; LEVEL;
D O I
10.18632/oncotarget.14506
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
AZD9291, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), benefits patients with T790M mutant non-small-cell lung cancer who fail treatment with first-generation EGFR TKIs. Acquisition of resistance to AZD9291 occurs inevitable and mechanisms need to be explored. We reported an advanced lung adenocarcinoma female with EGFR exon19 deletion treated on AZD9291 after failure of erlotinib and chemotherapy. Disease progressed again after 6 months' treatment of AZD9291 with hepatic metastasis. Re-biopsy of the hepatic lesion showed histopathology transformation to small cell lung cancer, which harbored EGFR exon19 deletion. Therefore, small cell carcinoma transformation is one of potential resistance mechanisms to AZD9291 and regimen for small cell carcinoma may be one of the treatment options.
引用
收藏
页码:18609 / 18614
页数:6
相关论文
共 14 条
[1]   Clinical correlation of extensive-stage small-cell lung cancer genomics [J].
Dowlati, A. ;
Lipka, M. B. ;
McColl, K. ;
Dabir, S. ;
Behtaj, M. ;
Kresak, A. ;
Miron, A. ;
Yang, M. ;
Sharma, N. ;
Fu, P. ;
Wildey, G. .
ANNALS OF ONCOLOGY, 2016, 27 (04) :642-647
[2]   Two Cases of Small Cell Lung Cancer Transformation from EGFR Mutant Adenocarcinoma During AZD9291 Treatment [J].
Ham, Jun Soo ;
Kim, Seokhwi ;
Kim, Hee Kyung ;
Byeon, Seonggyu ;
Sun, Jong-Mu ;
Lee, Se-hoon ;
Ahn, Jin Seok ;
Park, Keunchil ;
Choi, Yoon-La ;
Han, Joungho ;
Park, Woongyang ;
Ahn, Myung-Ju .
JOURNAL OF THORACIC ONCOLOGY, 2016, 11 (01) :E1-E4
[3]   AZD9291 in EGFR Inhibitor-Resistant Non-Small-Cell Lung Cancer [J].
Jaenne, Pasi A. ;
Yang, James Chih-Hsin ;
Kim, Dong-Wan ;
Planchard, David ;
Ohe, Yuichiro ;
Ramalingam, Suresh S. ;
Ahn, Myung-Ju ;
Kim, Sang-We ;
Su, Wu-Chou ;
Horn, Leora ;
Haggstrom, Daniel ;
Felip, Enriqueta ;
Kim, Joo-Hang ;
Frewer, Paul ;
Cantarini, Mireille ;
Brown, Kathryn H. ;
Dickinson, Paul A. ;
Ghiorghiu, Serban ;
Ranson, Malcolm .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (18) :1689-1699
[4]   Mechanisms of Acquired Resistance to AZD9291 A Mutation-Selective, Irreversible EGFR Inhibitor [J].
Kim, Tae Min ;
Song, Ahnah ;
Kim, Dong-Wan ;
Kim, Soyeon ;
Ahn, Yong-Oon ;
Keam, Bhumsuk ;
Jeon, Yoon Kyung ;
Lee, Se-Hoon ;
Chung, Doo Hyun ;
Heo, Dae Seog .
JOURNAL OF THORACIC ONCOLOGY, 2015, 10 (12) :1736-1744
[5]   The Allelic Context of the C797S Mutation Acquired upon Treatment with Third-Generation EGFR Inhibitors Impacts Sensitivity to Subsequent Treatment Strategies [J].
Niederst, Matthew J. ;
Hu, Haichuan ;
Mulvey, Hillary E. ;
Lockerman, Elizabeth L. ;
Garcia, Angel R. ;
Piotrowska, Zofia ;
Sequist, Lecia V. ;
Engelman, Jeffrey A. .
CLINICAL CANCER RESEARCH, 2015, 21 (17) :3924-3933
[6]   Transformation from non-small-cell lung cancer to small-cell lung cancer: molecular drivers and cells of origin [J].
Oser, Matthew G. ;
Niederst, Matthew J. ;
Sequist, Lecia V. ;
Engelman, Jeffrey A. .
LANCET ONCOLOGY, 2015, 16 (04) :E165-E172
[7]   High MET amplification level as a resistance mechanism to osimertinib (AZD9291) in a patient that symptomatically responded to crizotinib treatment post-osimertinib progression [J].
Ou, Sai-Hong Ignatius ;
Agarwal, Nikita ;
Ali, Siraj M. .
LUNG CANCER, 2016, 98 :59-61
[8]   Association Between Plasma Genotyping and Outcomes of Treatment With Osimertinib (AZD9291) in Advanced Non-Small-Cell Lung Cancer [J].
Oxnard, Geoffrey R. ;
Thress, Kenneth S. ;
Alden, Ryan S. ;
Lawrance, Rachael ;
Paweletz, Cloud P. ;
Cantarini, Mireille ;
Yang, James Chih-Hsin ;
Barrett, J. Carl ;
Janne, Pasi A. .
JOURNAL OF CLINICAL ONCOLOGY, 2016, 34 (28) :3375-+
[9]   Genotypic and Histological Evolution of Lung Cancers Acquiring Resistance to EGFR Inhibitors [J].
Sequist, Lecia V. ;
Waltman, Belinda A. ;
Dias-Santagata, Dora ;
Digumarthy, Subba ;
Turke, Alexa B. ;
Fidias, Panos ;
Bergethon, Kristin ;
Shaw, Alice T. ;
Gettinger, Scott ;
Cosper, Arjola K. ;
Akhavanfard, Sara ;
Heist, Rebecca S. ;
Temel, Jennifer ;
Christensen, James G. ;
Wain, John C. ;
Lynch, Thomas J. ;
Vernovsky, Kathy ;
Mark, Eugene J. ;
Lanuti, Michael ;
Iafrate, A. John ;
Mino-Kenudson, Mari ;
Engelman, Jeffrey A. .
SCIENCE TRANSLATIONAL MEDICINE, 2011, 3 (75)
[10]   Acquired EGFR C797S mutation mediates resistance to AZD9291 in non-small cell lung cancer harboring EGFR T790M [J].
Thress, Kenneth S. ;
Paweletz, Cloud P. ;
Felip, Enriqueta ;
Cho, Byoung Chul ;
Stetsonl, Daniel ;
Dougherty, Brian ;
Lai, Zhongwu ;
Markovets, Aleksandra ;
Vivancos, Ana ;
Kuang, Yanan ;
Ercan, Dalia ;
Matthews, Sarah E. ;
Cantarini, Mireille ;
Barrett, J. Carl ;
Jaenne, Pasi A. ;
Oxnard, Geoffrey R. .
NATURE MEDICINE, 2015, 21 (06) :560-562