Moffat Gordon Taylor, Wang Tao, Robinson Andrew G
Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.
Department of Oncology, Queen's University, Kingston, Ontario, Canada.
J Natl Compr Canc Netw. 2023 Feb 15;21(4):336-339. doi: 10.6004/jnccn.2022.7089.
This report describes the management of small cell lung cancer (SCLC) transformation in a patient with untreated ALK-mutated advanced disease and a minimal smoking history, and a separate case of a de novo SCLC in a lifelong nonsmoker found to have a potentially targetable ERBB2 alteration. In the first case, chemotherapy followed by a targeted inhibitor was chosen due to the presence of the ALK rearrangement, as well as a somewhat discordant response to induction chemotherapy, suggesting possible progression of the ALK inhibitor-sensitive component. Molecular testing for the identification of driver mutations should be considered in patients with SCLC who have light/never smoking histories in order to help understand the incidence and ultimate optimal management strategies.
本报告描述了一名未治疗的ALK突变晚期疾病且吸烟史极少的患者发生小细胞肺癌（SCLC）转化的管理情况，以及另一例终身不吸烟者新发SCLC的病例，该患者被发现存在潜在可靶向的ERBB2改变。在第一个病例中，由于存在ALK重排以及对诱导化疗的反应有些不一致，提示ALK抑制剂敏感成分可能进展，因此选择了化疗后使用靶向抑制剂。对于有轻度/无吸烟史的SCLC患者，应考虑进行分子检测以鉴定驱动突变，以帮助了解其发生率和最终的最佳管理策略。
