Afatinib/erlotinib

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Afatinib/erlotinib Malignant transformation of lung adenocarcinoma to neuroendocrine/ small cell carcinoma following drug resistance: case report

A 58-year-old woman experienced malignant transformation of adenocarcinoma to lung neuroendocrine/ small cell carcinoma following drug resistance during treatment with erlotinib and afatinib [routes, dosages, durations of treatments to reactions onsets and outcomes not stated]. The woman, who had been diagnosed with biopsy-proven epidermal growth factor receptor (EGFR) mutated adenocarcinoma lung cancer, started receiving erlotinib. After a few days, she developed pneumonitis [aetiology not stated]. Further, she received carboplatin and pemetrexed with progression of the disease. She was then started on afatinib, which showed response. At one year, CT scan revealed a new pulmonary nodule biopsy of which revealed T790 negative adenocarcinoma followed by cyberknife at the left upper lobe lesion. Subsequent CT scan showed multiple liver lesions. Thus, she underwent liver biopsy, and it demonstrated poorly differentiated neuroendocrine carcinoma/small cell carcinoma favouring lung primary with 90% mitotic activity. Based on the clinical picture, the malignant transformation of lung adenocarcinoma to neuroendocrine/ small cell carcinoma following erlotinib and afatinib resistance was noted. The woman was treated with carboplatin and etoposide, and a CT scan (December 2015) revealed treatment response. Subsequently, her clinical course was complicated with worsening performance status. A chest CT scan (August 2016) confirmed worsening disease with metastasis to brain. Later, she patient decided to pursue hospice care. Verma N, et al. Can one be transformed?. American Journal of Respiratory and Critical Care Medicine 199: abstr. A6997, No. 9, May 2019. Available from: URL: https:// 803447290 www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A6997 [abstract]

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Reactions 18 Jan 2020 No. 1787

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