The clinicopathologic of pulmonary adenocarcinoma transformation to small cell lung cancer
Related Experiment Video
Updated: Jan 27, 2026
Orthotopic Transplantation of Syngeneic Lung Adenocarcinoma Cells to Study PD-L1 Expression
Published on: January 19, 2019
Haiyan Yang1, Li Liu1, Chunhua Zhou1
1Department of Lung Cancer and Gastroenterology.
Abstract:
Transformation to small cell lung cancer (SCLC) is one of the mechanisms of resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). However, it is uncertain how it works and there is no standard treatment after the transformation. In this study, 7 patients with transformation of SCLC from advanced lung adenocarcinoma (ADC) were analyzed retrospectively and the clinical pathology, imaging characteristics and treatment were analyzed.We identified 7 patients with primary lung ADC that showed transformation to SCLC on second biopsy during a 6-year period. Clinicopathologic information was analyzed and EGFR mutation results were performed in initial biopsy samples.Seven patients showed transformation from ADC to SCLC, of which 6 patients were 19 del EGFR mutation, only 1 patient is L858R mutations. The imaging forms did not have the typical imaging features of primary SCLC. All patients underwent etoposide and carboplatin (EC) regimen chemotherapy after pathological transformation. However, the response rate of EC was less than primary small cell lung cancer. One of the patients was receiving EC for 4 cycles. After chemotherapy the patients performed radiation therapy and finally with erlotinib maintains treatment, the progress free survival (PFS) was more than 12 months.NSCLC can acquire a neuroendocrine phenotype with EGFR-TKI treatment. The transmutation is more common in 19del mutation patients. A comprehensive treatment based on EC regimen chemotherapy and the maintenance with EGFR-TKI is likely to be the appropriate treatment for these patients.
Insights
Small cell lung cancer (SCLC) transformation is a resistance mechanism to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). A combination of chemotherapy and EGFR-TKI maintenance therapy shows promise for treating this transformation.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Transformation to small cell lung cancer (SCLC) is a known resistance mechanism to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in advanced lung adenocarcinoma (ADC).
- The precise mechanisms driving this transformation and optimal post-transformation treatment strategies remain unclear.
- Understanding this phenomenon is crucial for improving outcomes in EGFR-TKI-treated lung cancer patients.
Purpose of the Study:
- To retrospectively analyze the clinical pathology, imaging characteristics, and treatment outcomes of patients with lung adenocarcinoma transforming into SCLC.
- To investigate the association between EGFR mutations and SCLC transformation.
- To evaluate the efficacy of different treatment regimens following SCLC transformation.
Main Methods:
- Retrospective analysis of 7 patients with primary lung ADC who developed SCLC transformation during EGFR-TKI treatment over a 6-year period.
- Review of clinicopathologic information, imaging findings, and treatment histories.
- Analysis of EGFR mutation status from initial biopsy samples.
Main Results:
- Six out of seven transforming patients harbored the EGFR 19 del mutation; one had an L858R mutation.
- The imaging features of transformed tumors did not consistently align with typical SCLC presentations.
- Etoposide and carboplatin (EC) chemotherapy showed a lower response rate compared to primary SCLC; however, one patient achieved >12 months progression-free survival with EC, radiation, and erlotinib maintenance.
Conclusions:
- Non-small cell lung cancer (NSCLC) can acquire a neuroendocrine phenotype during EGFR-TKI treatment, particularly in patients with the EGFR 19 del mutation.
- A comprehensive treatment approach combining EC chemotherapy with subsequent EGFR-TKI maintenance therapy appears to be a viable strategy for managing SCLC transformation.
- Further research is warranted to establish standardized treatment protocols for this specific clinical scenario.
More Related Videos
07:53Author Spotlight: Advancing 3D Modeling for Enhanced Diagnosis and Treatment of Pulmonary Nodules in Early-Stage Lung Cancer
Published on: October 13, 2023
13:18Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma
Published on: March 3, 2023
Related Concept Videos
01:18Distinctive Features of Adult Stem Cells vs Cancer Stem Cells
Adult stem cells
Adult stem cells are tissue-specific; hence, they divide to develop the tissue from which they originate. One type of adult stem cell is the epithelial stem cell, which gives rise to the keratinocytes in the multiple layers of epithelial cells in the epidermis of the skin. Adult bone marrow has three distinct types of stem cells:...
01:47Lung Capacity
01:33Bacterial Transformation
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...
01:26Transformation
01:26Transformers
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...
01:26The Ideal Transformer
Ampere's Law forms the basis of understanding the magnetic field within the transformer. It states that the integral of the magnetic field intensity's tangential...