Sato Mitsuo, Matsui Akira, Shimoyama Yoshie, Omote Norihito, Morise Masahiro, Hase Tetsunari, Tanaka Ichidai, Suzuki Kojiro, Hasegawa Yoshinori
Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan.
Department of Pathology, Nagoya University Graduate School of Medicine, Japan.
Intern Med. 2018 Dec 1;57(23):3429-3432. doi: 10.2169/internalmedicine.0999-18. Epub 2018 Aug 10.
Squamous cell carcinoma (SCC) transformation has been identified as a mechanism of resistance to first-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), gefitinib or erlotinib, in EGFR-mutated lung cancer. However, whether second- or third-generation TKIs can overcome resistance due to SCC transformation remains unclear. We herein report an EGFR-mutated lung adenocarcinoma undergoing transformation into SCC that exhibited a durable response to afatinib, which is a second-generation irreversible EGFR-TKI. We suggest that afatinib can be considered as a treatment option for EGFR-mutated tumor undergoing SCC transformation, particularly in the absence of a T790M mutation.
鳞状细胞癌（SCC）转化已被确定为表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）第一代药物吉非替尼或厄洛替尼耐药的机制，在EGFR突变的肺癌中。然而，第二代或第三代TKIs是否能克服SCC转化导致的耐药性仍不清楚。我们在此报告一例EGFR突变的肺腺癌转化为SCC，其对第二代不可逆EGFR-TKI阿法替尼表现出持久反应。我们建议，阿法替尼可被视为EGFR突变肿瘤发生SCC转化的一种治疗选择，特别是在不存在T790M突变的情况下。
