Histologic transformation of EGFR mutant lung adenocarcinoma without exposure to EGFR inhibition

Le, Thanh; Sailors, Joseph L.; Oliver, Dwight; Mayer, Melissa; Hoskin, Sharon; Gerber, David E.

doi:10.1016/j.lungcan.2017.01.005

Cited by 14 publications

(10 citation statements)

References 4 publications

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“…To date only clinical observation during treatment with immunotherapy can justify a biopsy in an non-responding metastatic site. Indeed we have observed in case reports that non-responding metastatic do not have molecular expression of the primary site (EGFR, ALK, ROS1, ALK or PD-L1) or there are cases where we have a different lung cancer or lung cancer transformation [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE^®

Sapalidis¹,

Petridis²,

Kosmıdis³

et al. 2019

J. Cancer

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Introduction: Lung cancer is diagnosed at advanced stage due to lack of early disease symptoms. Currently we have several different biopsy techniques such as; radial endobronchial ultrasound, convex probe endobronchial ultrasound, electromagnetic navigation, ct guided biospy and transthoracic ultrasound biopsy. Novel therapies such as; immunotherapy is being used for non-small cell lung cancer in the everyday clinical practice as first and second line treatment. Programmed ligand-1 is essential in order to administer immunotherapy as first line treatment. Patients and Methods: Two thousands and two patients were included in our study where programmed ligand 1 was evaluated with DAKO technique and BIOCARE ®. Cell blocks were obtain with convex probe ebus-tbna 22G needle. Results: The Deming regression between DAKO and BIOCARE clone revealed an amazingly strong linear relationship as the coefficient of determination indicated (R 2 =0.999) and the variance ratio close to 1 (0.978), proving that both techniques can equally well be substituted for each other. The regression coefficient equals to 1 and the intercept hardly differs from 0 (0.936). In practice, this relationship permits adopting the economically affordable BIOCARE clone for further medical considerations. Conclusion: No statistical difference was observed between DAKO and BIOCARE ® , therefore we propose that both techniques can be used in order to investigate the expression of programmed ligand 1 with safety. PD-L1 expression was higher in the central mass instead of the lymphnodes.

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Section: Discussionmentioning

confidence: 99%

EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE^®

Sapalidis¹,

Petridis²,

Kosmıdis³

et al. 2019

J. Cancer

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“…Previous studies show that, live kinase B1 (LKB1) inactivation can promote gradual transition from lung ADC to SCC in mouse model ( 10), leading to drug resistance through metabolic alteration (11). Transition of ADC-SCC with disease progression was also observed in lung cancer patients treated with chemotherapy and immunotherapy (12,13), indicating that ADC-SCC transition might be a common drug-resistance mechanism. To better understand the link between ADC-SCC transition and EGFR inhibition resistance, further experimental validation is required.…”

Section: Discussionmentioning

confidence: 99%

Case Report: EGFR-Positive Early-Stage Lung Adenocarcinoma Transforming to Squamous Cell Carcinoma After TKI Treatment

Liao

Liu

et al. 2021

Front. Oncol.

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The histological transformation from epidermal growth factor receptor (EGFR)-mutated adenocarcinoma (ADC) to squamous cell carcinoma (SCC) after tyrosine kinase inhibitor (TKI) treatment is rare. We present a case of a patient who transitioned from early-stage primary lung ADC with partial squamous differentiation, EGFR mutation and amplification, to adrenal gland metastasis as SCC with EGFR amplification disappearance 115-months after surgery, during which gefitinib and local radiotherapy were utilized for the metastasis in the right femoral head and mediastinal lymph nodes. This case might indicate a possible mechanism of EGFR inhibition resistance with SCC transition and EGFR amplification loss from the initially well-responding ADC, especially those with SCC or partial squamous differentiation. The optimal post-progression therapy for ADC-SCC patients is challenging and further studies are needed.

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“…The efficacy of osimertinib in the treatment of T790M-positive NSCLC has been demonstrated (19). As shown in Table I, a total of 18 cases of squamous cell transformation in lung adenocarcinoma harboring an EGFR-activating mutation after treatment with cytotoxic chemotherapy or EGFR-TKIs have been reported (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18); in 8 of those, the T790M mutation was also detected. These patients were treated with EGFR-TKIs as first-line therapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of osimertinib treatment on lung adenocarcinoma with squamous cell transformation harboring the T790M mutation: A case report and literature review

et al. 2019

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We herein report a case of squamous cell transformation combined with the epidermal growth factor receptor (EGFR) mutation T790M associated with acquired resistance to EGFR tyrosine kinase inhibitors (EGFR-TKIs) in a 73-year-old male patient diagnosed with stage IVA lung adenocarcinoma. Gene alterations were analyzed by collecting and studying pleural effusion at the time of diagnosis. Examination revealed an exon 19 deletion in the EGFR gene. Following treatment with the second-generation EGFR-TKI afatinib, squamous cell carcinoma was identified by performing a re-biopsy of the recurrent site. Although the levels of cytokeratin 19 fragment, which is a tumor marker for the follow-up of squamous cell carcinoma, were increased at that point, the levels of carcinoembryonic antigen, a marker particularly associated with adenocarcinoma, remained within normal limits. The T790M mutation and the original exon 19 deletion were detected simultaneously. The patient received treatment with the third-generation EGFR-TKI osimertinib, achieving a good clinical response. These findings suggest that osimertinib is beneficial for lung adenocarcinoma patients with squamous cell transformation harboring the T790M mutation.

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Histologic transformation of EGFR mutant lung adenocarcinoma without exposure to EGFR inhibition

Abstract: Resistance to EGFR kinase inhibitors appears to be invariable in the treatment of non-small cell lung cancer. Several mechanisms have been described. Here, we report the first case of histologic transformation of EGFR mutant lung adenocarcinoma without prior exposure to EGFR inhibition.

Cited by 14 publications

References 4 publications

EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE^®

EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE^®

Case Report: EGFR-Positive Early-Stage Lung Adenocarcinoma Transforming to Squamous Cell Carcinoma After TKI Treatment

Effect of osimertinib treatment on lung adenocarcinoma with squamous cell transformation harboring the T790M mutation: A case report and literature review

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Histologic transformation of EGFR mutant lung adenocarcinoma without exposure to EGFR inhibition

Abstract: Resistance to EGFR kinase inhibitors appears to be invariable in the treatment of non-small cell lung cancer. Several mechanisms have been described. Here, we report the first case of histologic transformation of EGFR mutant lung adenocarcinoma without prior exposure to EGFR inhibition.

Cited by 14 publications

References 4 publications

EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE®

EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE®

Case Report: EGFR-Positive Early-Stage Lung Adenocarcinoma Transforming to Squamous Cell Carcinoma After TKI Treatment

Effect of osimertinib treatment on lung adenocarcinoma with squamous cell transformation harboring the T790M mutation: A case report and literature review

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Product

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EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE^®

EBUS-TNBA 22G samples: Comparison of PD-L1 expression between DAKO and BIOCARE^®