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Nishimura J, Miyamoto Y, Fujimoto N, et al. Adenocarcinoma of the Lung Acquiring Resistance to Afatinib by Transformation to Small Cell Carcinoma: A Case Report. Case Rep Oncol. 2017;10(2):666-670doi: 10.1159/000479147.
Nishimura, J., Miyamoto, Y., Fujimoto, N., Ozeki, T., Takada, K., Asano, M., Fuchimoto, Y., Wada, S., Ozaki, S., & Kishimoto, T. (2017). Adenocarcinoma of the Lung Acquiring Resistance to Afatinib by Transformation to Small Cell Carcinoma: A Case Report. Case reports in oncology, 10(2), 666-670. https://doi.org/10.1159/000479147
Nishimura, Jun, et al. "Adenocarcinoma of the Lung Acquiring Resistance to Afatinib by Transformation to Small Cell Carcinoma: A Case Report." Case reports in oncology vol. 10,2 (2017): 666-670. doi: https://doi.org/10.1159/000479147
Nishimura J, Miyamoto Y, Fujimoto N, Ozeki T, Takada K, Asano M, Fuchimoto Y, Wada S, Ozaki S, Kishimoto T. Adenocarcinoma of the Lung Acquiring Resistance to Afatinib by Transformation to Small Cell Carcinoma: A Case Report. Case Rep Oncol. 2017 Jul 21;10(2):666-670. doi: 10.1159/000479147. eCollection 2017. PMID: 28878647; PMCID: PMC5582498.
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Case Rep Oncol. 2017 Jul 21;10(2):666-670. doi: 10.1159/000479147. eCollection 2017.

Adenocarcinoma of the Lung Acquiring Resistance to Afatinib by Transformation to Small Cell Carcinoma: A Case Report.

Case reports in oncology

Jun Nishimura, Yosuke Miyamoto, Nobukazu Fujimoto, Taichi Ozeki, Kenji Takada, Michiko Asano, Yasuko Fuchimoto, Sae Wada, Shinji Ozaki, Takumi Kishimoto

Affiliations

  1. Department of Medicine, Okayama Rosai Hospital, Okayama, Japan.
  2. Department of Pulmonary Medicine, Okayama Rosai Hospital, Okayama, Japan.
  3. Department of Medical Oncology, Okayama Rosai Hospital, Okayama, Japan.

PMID: 28878647 PMCID: PMC5582498 DOI: 10.1159/000479147

Abstract

A 65-year-old woman visited our hospital due to right chest pain and dyspnea on exertion. Chest radiography revealed decreased permeability of the right lung. Computed tomography demonstrated a huge mass in the right upper lobe and right pleural effusion. Right pleural effusion cytology yielded a diagnosis of adenocarcinoma and was positive for mutation of epidermal growth factor receptor (EGFR; exon 21 L858R). Afatinib was selected for the initial treatment. Multiple tumors regressed remarkably, but then rapidly progressed 3 months later. We performed re-biopsy to detect the mechanism of resistance to afatinib. Histopathology revealed a mixture of small cell carcinoma (SCC) and adenocarcinoma harboring same EGFR mutation. To the best of our knowledge, this is the first report of transformation to SCC after treatment with afatinib.

Keywords: Adenocarcinoma; Afatinib; Drug resistance; Irinotecan; Small cell carcinoma; Transformation

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