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[Non-Small Cell Lung Cancer - Development of Parallel Mechanisms of Resistance]

M Moeller1, U Siebolts2, C Wickenhauser2

  • 1Klinik für Innere Medizin II, Krankenhaus Martha-Maria Halle-Dölau.

Pneumologie (Stuttgart, Germany)
|February 22, 2018
PubMed

Insights

Acquired resistance to lung cancer drugs is common. This case shows a patient developing two resistance types simultaneously: an EGFR mutation and cancer transformation, with partial response to treatment.

Area of Science:

  • Oncology
  • Molecular Biology
  • Cancer Genetics

Background:

  • Non-small cell lung cancer (NSCLC) frequently develops resistance to tyrosine kinase inhibitors (TKIs) within 9-12 months.
  • The EGFR T790M mutation is a common cause (60%) of acquired resistance in NSCLC patients.

Observation:

  • This report details a unique NSCLC case with concurrent development of two distinct resistance mechanisms.
  • The patient exhibited both the EGFR T790M resistance mutation and a histological transformation to small cell neuroendocrine carcinoma.

Findings:

  • The patient received Osimertinib combined with carboplatin and etoposide chemotherapy.
  • A partial response of the tumor to the combined therapy was observed despite the dual resistance mechanisms.

Implications:

  • This case highlights the complex resistance pathways in NSCLC, including co-occurring genetic mutations and histological changes.
  • Understanding these parallel resistance mechanisms is crucial for developing more effective, personalized treatment strategies for advanced NSCLC.
  • Further research is needed to explore therapeutic approaches for patients with combined resistance profiles.

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