Wang Diming, Ye Wei, Chen Dongmei, Shi Qingming, Ma Dongchun
Department of Oncology, Anhui Chest Hospital, Hefei, 230022, People's Republic of China.
Department of Pathology, Anhui Chest Hospital, Hefei, 230022, People's Republic of China.
Cancer Manag Res. 2023 Aug 10;15:803-808. doi: 10.2147/CMAR.S420485. eCollection 2023.
The transformation of lung adenocarcinoma to small cell lung cancer (SCLC) following treatment with epidermal growth factor (EGFR) receptor tyrosine kinase inhibitors (TKIs) is a relatively common phenomenon. However, transformation of non-small cell lung cancer (NSCLC) to SCLC following treatment with immunotherapy is very rare. Here, we report a case of a 56-year-old patient diagnosed with driver gene mutation-negative lung squamous cell carcinoma (SCC). He received four cycles of immunotherapy with sugemalimab and chemotherapy with albumin paclitaxel in combination with carboplatin, and a partial response was achieved. Subsequently, the patient received 5 cycles of immunotherapy with sugemalimab. However, he developed rapid progression of mediastinal lymph nodes, and biopsy results showed transformation to SCLC. His tumor did not respond to the next line of carboplatin combined with etoposide, and he died six months after the discovery of SCLC transformation. In conclusion, SCLC transformation is also an important resistance mechanism for lung SCC patients treated with immunotherapy and predicts a very poor outcome. Repeat biopsy is needed for advanced lung SCC that has progressed with immunotherapy.
表皮生长因子（EGFR）受体酪氨酸激酶抑制剂（TKIs）治疗后肺腺癌转化为小细胞肺癌（SCLC）是一种相对常见的现象。然而，免疫治疗后非小细胞肺癌（NSCLC）转化为SCLC非常罕见。在此，我们报告一例56岁诊断为驱动基因突变阴性肺鳞状细胞癌（SCC）的患者。他接受了4个周期的苏金单抗免疫治疗以及白蛋白紫杉醇联合卡铂化疗，并取得部分缓解。随后，该患者接受了5个周期的苏金单抗免疫治疗。然而，他出现纵隔淋巴结快速进展，活检结果显示已转化为SCLC。其肿瘤对下一线的卡铂联合依托泊苷治疗无反应，在发现SCLC转化6个月后死亡。总之，SCLC转化也是接受免疫治疗的肺SCC患者的一种重要耐药机制，且预示预后极差。对于接受免疫治疗后病情进展的晚期肺SCC患者，需要重复活检。
