Open AccessConcomitant T790M mutation and small‐cell lung cancer transformation after acquired resistance to epidermal growth factor receptor‐tyrosine kinase inhibitor
Author(s) -
Fujita Kohei,
Kim Young Hak,
Yoshizawa Akihiko,
Mio Tadashi,
Mishima Michiaki
Publication year - 2017
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.206
Subject(s) - t790m , epidermal growth factor receptor , medicine , lung cancer , erlotinib , concomitant , tyrosine kinase inhibitor , cancer research , adenocarcinoma , erlotinib hydrochloride , pathology , gefitinib , oncology , cancer
A 70‐year‐old man was admitted to our hospital with an abnormal chest X‐ray shadow. Bronchoscopy revealed an adenocarcinoma tumour with an epidermal growth factor receptor ( EGFR ) exon 19 deletion. Positron emission tomography–computed tomography scanning and magnetic resonance imaging showed advanced stage IV lung cancer. He was treated with erlotinib as a first‐line drug, which maintained a clinical response for 16 months. After disease progression, a re‐biopsy was done from the tumour in the right lower lobe. The obtained specimen harboured both small‐cell lung cancer ( SCLC ) transformation with retention of the EGFR 19 deletion and the development of an EGFR T790M mutation. We came across a very rare condition of concomitant T790M mutation and SCLC transformation after acquired resistance to EGFR ‐tyrosine kinase inhibitor.