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Published on: August 11, 2017
Transformation from adenocarcinoma to squamous cell carcinoma associated with long-term administration of EGFR-TKIs
Tomohiro Haruki1, Atsuyuki Nakanishi1, Shinji Matsui1
1Division of General Thoracic Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8504, Japan.
Abstract:
Although patients with non-small cell lung cancer exhibiting EGFR mutations generally respond to tyrosine kinase inhibitors (TKIs), the majority of patients acquire resistance ~1 year after treatment. EGFR T790M mutations, MET or HER2 amplifications and phenotypic transformations contribute to the mechanism of EGFR-TKI resistance. The transformation of small cell lung cancer frequently occurs, although few convert to squamous cell carcinoma associated with the administration of EGFR-TKIs. The current study reports a case of EGFR-mutated adenocarcinoma of the lung that transitioned to squamous cell carcinoma in association with long-term EGFR-TKIs administration.
Insights
Patients with EGFR-mutated lung cancer often develop resistance to TKIs. This study details a rare case where lung adenocarcinoma transformed into squamous cell carcinoma after long-term TKI treatment.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Non-small cell lung cancer (NSCLC) with EGFR mutations typically responds to tyrosine kinase inhibitors (TKIs).
- Acquired resistance to EGFR-TKIs is common, occurring in most patients within a year.
- Mechanisms of resistance include EGFR T790M mutations, MET/HER2 amplifications, and phenotypic transformation.
Purpose of the Study:
- To report a rare case of phenotypic transformation in EGFR-mutated lung adenocarcinoma.
- To investigate the transition to squamous cell carcinoma under long-term EGFR-TKI therapy.
Main Methods:
- Case study analysis
- Review of patient's clinical history and treatment response
- Histopathological examination of tumor samples
Main Results:
- The patient's EGFR-mutated lung adenocarcinoma transformed into squamous cell carcinoma.
- This transformation occurred during long-term administration of EGFR-TKIs.
- Phenotypic transformation is a recognized, though infrequent, mechanism of EGFR-TKI resistance.
Conclusions:
- Phenotypic transformation to squamous cell carcinoma can occur in EGFR-mutated lung adenocarcinoma during EGFR-TKI treatment.
- This highlights the complex mechanisms of acquired resistance to targeted cancer therapies.
- Further research is needed to understand and overcome such transformations.
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