Open AccessHistological conversion from adenocarcinoma to small cell carcinoma of the lung after treatment with an immune checkpoint inhibitor: a case report
Author(s) -
Naruhisa Miura,
Taichi Matsubara,
Shinkichi Takamori,
Naoki Haratake,
Ryo Toyozawa,
Masafumi Yamaguchi,
Takashi Seto,
Kenichi Taguchi,
Mitsuhiro Takenoyama
Publication year - 2020
Publication title -
oxford medical case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.169
H-Index - 9
ISSN - 2053-8855
DOI - 10.1093/omcr/omaa026
Subject(s) - medicine , adenocarcinoma , lung cancer , epidermal growth factor receptor , enolase , small cell carcinoma , irinotecan , cancer research , pembrolizumab , carcinoma , gefitinib , pathology , oncology , cancer , immunotherapy , immunohistochemistry , colorectal cancer
The transformation of adenocarcinoma to small cell lung cancer has been reported as acquisition of resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors. We here report a patient who presented histologically confirmed transformation of adenocarcinoma to small cell lung cancer after treatment with immune checkpoint inhibitor. A 65-year-old man was treated with pembrolizumab as first-line therapy and achieved temporarily a stable disease with progression after six cycles of this agent. At that stage, a transbronchial biopsy showed small cell lung cancer, and he was found to have high serum concentrations of neuron-specific enolase despite concentrations of numerous tumor markers, including neuron-specific enolase, having been within normal limits at the time of presentation. The patient thereafter was treated as a small cell carcinoma patient using cisplatin plus irinotecan and amrubicin.