Otoshi Ryota, Sekine Akimasa, Okudela Koji, Asaoka Masato, Sato Yozo, Ikeda Satoshi, Baba Tomohisa, Komatsu Shigeru, Hagiwara Eri, Ogura Takashi
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa 236-0051, Japan.
Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0027, Japan.
Mol Clin Oncol. 2020 Aug;13(2):129-132. doi: 10.3892/mco.2020.2059. Epub 2020 Jun 3.
The present report describes a case of a 68-year-old male patient with epidermal growth factor receptor (EGFR)-mutant non-small cell lung carcinoma (NSCLC). After cytotoxic chemotherapy of three regimens following 22 months of treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKIs), including osimertinib, the patient underwent S-1 treatment. Despite a decrease in carcinoembryonic antigen 1 month after initiating S-1 treatment, the patient developed cardiac tamponade. The evaluation of pericardial effusion confirmed small-cell lung carcinoma (SCLC) transformation. Subsequently, a combination therapy of carboplatin and etoposide was administered, which led to a marked improvement in imaging. In patients with NSCLC who develop pericardial effusion after long-term EGFR-TKI therapy, including osimertinib treatment, it is important to investigate whether SCLC transformation occurs or not as a treatable entity.
本报告描述了一例68岁男性表皮生长因子受体（EGFR）突变型非小细胞肺癌（NSCLC）患者。在用包括奥希替尼在内的EGFR酪氨酸激酶抑制剂（EGFR-TKIs）治疗22个月后，患者接受了三种方案的细胞毒性化疗，之后接受了S-1治疗。尽管在开始S-1治疗1个月后癌胚抗原有所下降，但患者出现了心脏压塞。心包积液评估证实发生了小细胞肺癌（SCLC）转化。随后给予了卡铂和依托泊苷联合治疗，影像学表现有显著改善。对于接受包括奥希替尼治疗在内的长期EGFR-TKI治疗后出现心包积液的NSCLC患者，重要的是要调查是否发生了SCLC转化，因为这是一个可治疗的情况。
