Liao Jiatao, Li Yuan, Liu Chang, Long Qianqian, Wang Jialei
Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Front Oncol. 2021 Jun 8;11:696881. doi: 10.3389/fonc.2021.696881. eCollection 2021.
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, mutation and amplification, to adrenal gland metastasis as SCC with 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 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.
酪氨酸激酶抑制剂（TKI）治疗后，表皮生长因子受体（EGFR）突变的腺癌（ADC）组织学转变为鳞状细胞癌（SCC）的情况罕见。我们报告一例患者，其从伴有部分鳞状分化、突变和扩增的早期原发性肺ADC，转变为术后115个月出现肾上腺转移的SCC，且扩增消失，期间对右股骨头和纵隔淋巴结转移灶使用了吉非替尼和局部放疗。该病例可能提示了EGFR抑制耐药的一种可能机制，即从最初反应良好的ADC转变为SCC并出现扩增缺失，尤其是那些伴有SCC或部分鳞状分化的ADC。ADC-SCC患者进展后的最佳治疗具有挑战性，需要进一步研究。
