Vol 16, No 3 (2020)
Case report
Published online: 2020-04-16

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Transformation of lung adenocarcinoma treated with afatinib into small-cell carcinoma — a case report

Monika Misztal1, Magdalena Krakowska1, Mariusz Śliwa1, Piotr Potemski12
Oncol Clin Pract 2020;16(3):140-142.


In patients with advanced lung adenocarcinoma harbouring EGFR mutations, the use of molecularly targeted therapy has significantly increased progression-free survival (PFS) and in some studies also overall survival (OS). Unfortunately, during therapy all patients develop resistance. In about half of the cases the cause of progression is the appearance of the T790M mutation of the EGFR gene. Other described resistance mechanisms are as follows: transformation into small-cell carcinoma (14%), MET amplification (5%), and PIK3CA mutations (5%). Herein we report the case of patient with disseminated lung adenocarcinoma treated with a tyrosine kinase inhibitor (afatinib), whose disease progressed after 13 months of treatment as a result of transformation into small-cell carcinoma. Despite palliative chemotherapy with cisplatin and etoposide, the patient died six months later.

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