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Histological transformation of non-small-cell lung cancer: A neglected entity
Antara Sanyal1, Soumya S Panda1, Debahuti Mohapatra2
1Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India.
Abstract:
Despite having targetable mutations, lung cancer remains incurable. This is a case of a 51-year-old lady with metastatic adenocarcinoma of the lung, harboring a mutation in EGFR exon 19. She underwent a histological transformation after multiple lines of treatment (including tyrosine kinase inhibitor (TKI)). Despite being a known pathway for acquired resistance, the histological conversion from non-small-cell to small-cell histology is often overlooked or misdiagnosed due to various reasons. There are very few studies focusing on genetic mutations in histologically transformed lung cancer. A next-generation sequencing (NGS), in our case, showed PI3KCA mutation along with in-frame deletion of EGFR.
Insights
Histological transformation in lung cancer, from non-small-cell to small-cell, can occur after tyrosine kinase inhibitor (TKI) treatment. Genetic analysis revealed PI3KCA mutation alongside EGFR deletion in a transformed lung adenocarcinoma case.
Area of Science:
- Oncology
- Genetics
- Pulmonology
Background:
- Lung cancer, despite targeted therapies, remains a significant challenge.
- Acquired resistance mechanisms, such as histological transformation, are critical in treatment failure.
- Transformation from non-small-cell lung cancer (NSCLC) to small-cell lung cancer (SCLC) is an underdiagnosed cause of treatment failure.
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