Related Experiment Video

Updated: Feb 11, 2026

Establishment and Characterization of Three Afatinib-resistant Lung Adenocarcinoma PC-9 Cell Lines Developed with Increasing Doses of Afatinib
09:38

Establishment and Characterization of Three Afatinib-resistant Lung Adenocarcinoma PC-9 Cell Lines Developed with Increasing Doses of Afatinib

Published on: June 26, 2019

8.4K

Transformation to small cell lung cancer after first-line afatinib treatment

Takayuki Shiroyama1, Shingo Nasu1, Ayako Tanaka1

  • 1Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan.

Respiratory Medicine Case Reports
|May 3, 2018
PubMed

Insights

Acquired resistance to EGFR-TKIs can occur through transformation to small cell lung cancer (SCLC). Rebiopsy is crucial for diagnosis, even with normal tumor markers, in EGFR-mutated lung adenocarcinoma patients.

Area of Science:

  • Oncology
  • Genetics
  • Molecular Biology

Background:

  • Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are standard treatments for EGFR-mutated lung adenocarcinoma.
  • Acquired resistance to EGFR-TKIs is a significant clinical challenge.
  • Transformation to small cell lung cancer (SCLC) is a recognized mechanism of acquired resistance.

Observation:

  • A 35-year-old male with EGFR exon 19 deletion lung adenocarcinoma developed resistance to afatinib after 7 months.
  • Rebiopsy revealed transformation to SCLC, still harboring the EGFR exon 19 deletion.
  • Serum neuron-specific enolase and pro-gastrin releasing peptide levels were within normal ranges.

Findings:

  • SCLC transformation can occur in EGFR-mutated lung adenocarcinoma despite initial response to EGFR-TKIs.
  • EGFR mutations can persist in the SCLC component after transformation.
  • Normal tumor marker levels do not rule out SCLC transformation.

Implications:

  • Rebiopsy is essential for identifying SCLC transformation as a cause of acquired resistance to EGFR-TKIs.
  • This case underscores the importance of considering histological transformation in treatment-resistant EGFR-mutated lung cancers.
  • Clinical management strategies may need to adapt to account for SCLC transformation in lung adenocarcinoma.
Keywords:
Acquired resistanceAdenocarcinomaAfatinibRebiopsySmall cell lung cancerTransformation

More Related Videos

Radiosensitivity of Cancer Stem Cells in Lung Cancer Cell Lines09:45

Radiosensitivity of Cancer Stem Cells in Lung Cancer Cell Lines

Published on: August 21, 2019

7.5K
Detection of Targetable Alterations in Non-small Cell Lung Cancer using Next-generation Sequencing05:17

Detection of Targetable Alterations in Non-small Cell Lung Cancer using Next-generation Sequencing

Published on: October 10, 2025

424

Related Concept Videos

Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.8K
Bacterial Transformation01:33

Bacterial Transformation

In 1928, bacteriologist Frederick Griffith worked on a vaccine for pneumonia, which is caused by Streptococcus pneumoniae bacteria. Griffith studied two pneumonia strains in mice: one pathogenic and one non-pathogenic. Only the pathogenic strain killed host mice.
Griffith made an unexpected discovery when he killed the pathogenic strain and mixed its remains with the live, non-pathogenic strain. Not only did the mixture kill host mice, but it also contained living pathogenic bacteria that...
60.1K
Lung Capacity01:47

Lung Capacity

The air in the lungs is measured in volumes and capacities. Lung volume measures reflect the amount of air taken in, released, or left over after a lung function, like a single inhalation. Lung capacity measures are sums of two or more lung volume measures.
56.4K
Transformers01:26

Transformers

A device that transforms voltages from one value to another using induction is called a transformer. A transformer consists of two separate coils, or windings, wrapped around the same soft iron core. However, they are electrically insulated from each other.
The iron core has a substantial relative permeability. Therefore, the magnetic field lines generated due to the current in one winding are almost entirely confined within the core, such that the same magnetic flux permeates each turn of both...
1.9K
Transformation01:26

Transformation

Microbial communities are dynamic environments where cell lysis releases free DNA into the surroundings. Other cells can take up this extracellular DNA through a process known as transformation.When a cell incorporates this foreign DNA into its genome, resulting in genetic modification, the process is known as transformation. Cells capable of this process are termed competent. Competence can be natural, as observed in certain bacteria and archaea, or artificially induced in the...
1.1K
Transformations of Functions I01:29

Transformations of Functions I

A function's graph can be modified by changing its position or size without altering its overall shape. These transformations allow the graph to be moved across the coordinate plane while preserving its pattern and structure. One of the most common transformations is shifting, which repositions the graph without distorting it.When the output of a function is adjusted by adding or subtracting a constant, the graph shifts vertically. A positive value moves the graph upward, while a negative value...
204