Small-cell carcinoma with an epidermal growth factor receptor mutation in a never-smoker with gefitinib-responsive adenocarcinoma of the lung.


:Activating mutations in the epidermal growth factor receptor (EGFR) gene are extremely rare in small-cell lung cancer (SCLC). Here, we present a case of an EGFR-mutant gefitinib-responsive non-small-cell lung cancer (NSCLC) of adenocarcinoma histology occurring in a never-smoker followed by subsequent diagnosis of metastatic SCLC carrying an EGFR mutation. Although gefitinib therapy of the primary NSCLC resulted in disease control for over 3 years, the patient subsequently developed metastatic SCLC to the liver. Epidermal growth factor receptor mutation analysis revealed that the exon 21 L858R activating mutation was present in both the original lung adenocarcinoma and the metastatic SCLC. We hypothesize that SCLC either evolved from the previously diagnosed NSCLC or that both arose from a common precursor. Further comparative molecular analysis of these histologically distinct tumors would be of value to better understand the potential role of EGFR in the pathogenesis of SCLC in never-smokers, and the role of selection for an EGFR-mutant SCLC subclone as an unusual mechanism of acquired resistance to EGFR inhibitors in NSCLC.


Clin Lung Cancer


Clinical lung cancer


Alam N,Gustafson KS,Ladanyi M,Zakowski MF,Kapoor A,Truskinovsky AM,Dudek AZ




Has Abstract


2010-09-01 00:00:00














  • Clinical Impact of Gastric Acid-Suppressing Medication Use on the Efficacy of Erlotinib and Gefitinib in Patients With Advanced Non-Small-Cell Lung Cancer Harboring EGFR Mutations.

    abstract:BACKGROUND:Gastric acid-suppressing medications (AS), namely, proton pump inhibitors and histamine-2 receptor antagonists, increase gastric pH, which may reduce the absorption of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors-erlotinib and gefitinib. PATIENTS AND METHODS:From 2008 to 2011, 130 ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Zenke Y,Yoh K,Matsumoto S,Umemura S,Niho S,Ohmatsu H,Goto K,Ohe Y

    更新日期:2016-09-01 00:00:00

  • Antisense oligonucleotides in the treatment of non-small-cell lung cancer.

    abstract::Antisense oligonucleotides (ASONs) are one of the new classes of molecularly targeted agents that have transitioned from the laboratory into clinical trials. Rational drug design has resulted in agents directed against a number of important cellular targets, including the mRNA of bcl-2, protein kinase (PK) C-alpha, PK...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Davies AM,Gandara DR,Lara PN Jr,Mack PC,Lau DH,Gumerlock PH

    更新日期:2003-01-01 00:00:00

  • Results from a single institution phase II trial of concurrent docetaxel/carboplatin/radiotherapy followed by surgical resection and consolidation docetaxel/carboplatin in stage III non-small-cell lung cancer.

    abstract:BACKGROUND:The optimal treatment of locally advanced non-small-cell lung cancer (NSCLC) remains controversial. We hypothesized that using a trimodality approach in selected patients with stage IIIA/IIIB disease would be both feasible and efficacious with reasonable toxicity. PATIENTS/METHODS:We enrolled 13 patients wi...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Das M,Donington JS,Murphy J,Kozak M,Eclov N,Whyte RI,Hoang CD,Zhou L,Le QT,Loo BW,Wakelee H

    更新日期:2011-09-01 00:00:00

  • Comparison of Radiotherapy and Chemoradiotherapy for Locoregional Recurrence of Non-small-cell Lung Cancer Developing After Surgery.

    abstract:BACKGROUND:The optimal treatment strategy for locoregional recurrences developing after surgical resection in patients with non-small-cell lung cancer (NSCLC) is yet to be clearly established. PATIENTS AND METHODS:To investigate the efficacy and safety of radiotherapy (RT) and chemoradiotherapy (CRT), we reviewed the ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Nakamichi S,Horinouchi H,Asao T,Goto Y,Kanda S,Fujiwara Y,Nokihara H,Yamamoto N,Ito Y,Watanabe SI,Ohe Y

    更新日期:2017-11-01 00:00:00

  • Maintenance or Consolidation Therapy for Non--Small-Cell Lung Cancer: A Meta-Analysis Involving 5841 Subjects.

    abstract:INTRODUCTION:Maintenance therapy is a new treatment paradigm for advanced non-small-cell lung cancer (NSCLC). We conducted a meta-analysis to evaluate its clinical efficacy in NSCLC and compared the efficacy of chemotherapy, epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), and other treatment ap...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,meta分析


    authors: Zhang C,Huang C,Wang J,Wang X,Li K

    更新日期:2015-09-01 00:00:00

  • Association Between Environmental Tobacco Smoke Exposure and the Occurrence of EGFR Mutations and ALK Rearrangements in Never-smokers With Non-Small-cell Lung Cancer: Analyses From a Prospective Multinational ETS Registry.

    abstract:BACKGROUND:Molecular studies have demonstrated actionable driver oncogene alterations are more frequent in never-smokers with non-small-cell lung cancer (NSCLC). The etiology of these driver oncogenes in patients with NSCLC remains unknown, and environmental tobacco smoke (ETS) is a potential cause in these cases. MAT...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Soo RA,Kubo A,Ando M,Kawaguchi T,Ahn MJ,Ou SI

    更新日期:2017-09-01 00:00:00

  • Placebo-controlled trial of bexarotene, a retinoid x receptor agonist, as maintenance therapy for patients treated with chemotherapy for advanced non-small-cell lung cancer.

    abstract::This study was designed as a multicenter, randomized, double-blind, placebo-controlled trial. Patients were randomized by center to placebo (16 patients, 31%), oral bexarotene 300 mg/m2/day (21 patients, 40%), or oral bexarotene 600 mg/m2/day (15 patients, 29%) following demonstration of stable or responsive disease a...

    journal_title:Clinical lung cancer

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Rizvi N,Hawkins MJ,Eisenberg PD,Yocum RC,Reich SD,Ligand L1069-20 Working Group.

    更新日期:2001-02-01 00:00:00

  • Symptom and Quality of Life Improvement in LUX-Lung 8, an Open-Label Phase III Study of Second-Line Afatinib Versus Erlotinib in Patients With Advanced Squamous Cell Carcinoma of the Lung After First-Line Platinum-Based Chemotherapy.

    abstract:INTRODUCTION:In the phase III LUX-Lung 8 trial, afatinib significantly improved progression-free survival (PFS) and overall survival (OS) versus erlotinib in patients with squamous cell carcinoma (SCC) of the lung progressing during or after platinum-based chemotherapy. Patient-reported outcomes (PROs) and health-relat...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,随机对照试验


    authors: Felip E,Hirsh V,Popat S,Cobo M,Fülöp A,Dayen C,Trigo JM,Gregg R,Waller CF,Soria JC,Goss GD,Gordon J,Wang B,Palmer M,Ehrnrooth E,Gadgeel SM

    更新日期:2018-01-01 00:00:00

  • Future trends in patient-reported outcomes assessment for patients with advanced-stage lung cancer receiving targeted therapy.

    abstract::Recent advances in cancer cell biology have led to the development of therapeutic agents that target pathways critical to the development and progression of disease. These so-called "targeted therapies" might offer patients a more tolerable alternative to traditional systemic chemotherapy that often achieves therapeut...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Eton DT,Yost KJ,Cella D

    更新日期:2006-09-01 00:00:00

  • Current development of adjuvant treatment of non-small-cell lung cancer.

    abstract::Although radical surgery remains the mainstay therapeutic modality for early-stage non-small-cell lung cancer (NSCLC), long-term survival of patients with completely resected NSCLC tumors remains suboptimal. Globally, the 5-year survival rate of patients who undergo complete surgical resection is in the range of 40%-5...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Scagliotti GV,Novello S

    更新日期:2004-12-01 00:00:00

  • Quality of life and the treatment of advanced lung cancer.

    abstract::Lung cancer is the leading cause of cancer deaths worldwide, with the majority of patients presenting with advanced disease. Despite the introduction of newer therapeutic agents and modest survival improvement, the overall prognosis for these patients is poor. The goals of therapy should therefore include improvement ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Plunkett TA,Chrystal KF,Harper PG

    更新日期:2003-07-01 00:00:00

  • Clinical Impact of Frequent Surveillance Imaging in the First Year Following Chemoradiation for Locally Advanced Non-small-cell Lung Cancer.

    abstract:OBJECTIVE:Uncertainty exists regarding the optimal surveillance imaging schedule following definitive chemoradiation (CRT) for locally advanced non-small-cell lung cancer (LA-NSCLC) with regards to both frequency and modality. We sought to document the clinical impact of frequent (at least every 4 months) surveillance ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Ho QA,Harandi NK,Daly ME

    更新日期:2017-07-01 00:00:00

  • Chemotherapy and Radiation Versus Chemotherapy Alone for Elderly Patients With N3 Stage IIIB NSCLC.

    abstract:BACKGROUND:Standard treatment for stage III non-small-cell lung cancer (NSCLC) is concurrent chemotherapy and radiation (chemo-RT). However, N3 stage IIIB disease portends a worse prognosis and the tolerability of chemo-RT in patients ≥70 years old is a concern. In this analysis, we evaluate the survival of patients wi...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Qin A,Lusk E,Daignault-Newton S,Schneider BJ

    更新日期:2019-07-01 00:00:00

  • Structural basis for hyperpermeability of tumor vessels in advanced lung adenocarcinoma complicated by pleural effusion.

    abstract:BACKGROUND:Malignant pleural effusion (MPE) has a profound impact on quality of life and survival in patients with lung cancer. Identification of the factors within the tumor and its environment that mediate MPE is still lacking. PATIENTS AND METHODS:Intratumoral microvessel density (MVD), endothelial cell and pericyt...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Damianovich M,Hout Siloni G,Barshack I,Simansky DA,Kidron D,Dar E,Avivi C,Onn A

    更新日期:2013-11-01 00:00:00

  • Prevalence and clinical significance of incidental and clinically suspected venous thromboembolism in lung cancer patients.

    abstract:BACKGROUND:It is unclear what proportion of VTE events in lung cancer patients are incidentally discovered and whether incidental events affect mortality. PATIENTS AND METHODS:We conducted a retrospective cohort study of lung cancer patients seen at the University of Rochester between January 1, 2006 and December 31, ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Connolly GC,Menapace L,Safadjou S,Francis CW,Khorana AA

    更新日期:2013-11-01 00:00:00

  • Treatment Response and Prophylactic Cranial Irradiation Are Prognostic Factors in a Real-life Limited-disease Small-cell Lung Cancer Patient Cohort Comprehensively Staged With Cranial Magnetic Resonance Imaging.

    abstract:INTRODUCTION:Prophylactic cranial irradiation (PCI) has proven to decrease the incidence of brain metastases (BMs), with a modest improvement in survival. PATIENTS AND METHODS:The impact of PCI was evaluated in 184 patients treated with chemoradiotherapy. PCI was applied to patients with disease with partial and compl...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Eze C,Roengvoraphoj O,Niyazi M,Hildebrandt G,Fietkau R,Belka C,Manapov F

    更新日期:2017-07-01 00:00:00

  • Patients with lung cancer with metachronous or synchronous gastric cancer.

    abstract:BACKGROUND:There are few reports of treatment and outcome for patients with metachronous or synchronous lung and gastric cancers. To evaluate them, we conducted a retrospective study. PATIENTS AND METHODS:The medical records of patients with lung cancer who previously or simultaneously had gastric cancer seen in our d...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Kurishima K,Satoh H,Kagohashi K,Homma S,Nakayama H,Ohara G,Ishikawa H,Hizawa N

    更新日期:2009-11-01 00:00:00

  • The potential role of bortezomib in combination with chemotherapy and radiation in non-small-cell lung cancer.

    abstract::The combination of chemotherapy and radiation has been validated for the treatment of locally advanced non-small-cell lung cancer (NSCLC). However, the results are still unsatisfactory, and there is a need to improve current treatment. One approach is to use new agents that have the potential to enhance the efficacy o...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Edelman MJ

    更新日期:2005-10-01 00:00:00

  • First-in-Human Phase 1 Study of ES-072, an Oral Mutant-Selective EGFR T790M Inhibitor, in Non-Small-Cell Lung Cancer.

    abstract:BACKGROUND:Third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are rapidly being developed for treatment of non-small-cell lung cancer (NSCLC) in patients harboring EGFR T790M mutations. This first-in-human phase 1 study evaluated the maximum tolerated dose, recommended phase 2 do...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Zheng J,Shen L,Jiang N,Zhu Y,Wu L,Cao H,Sun W,Zhou J,Zhou J

    更新日期:2020-11-01 00:00:00

  • A Retrospective Study of Stage I to IIIa Lung Adenocarcinoma After Resection: What Is the Optimal Adjuvant Modality for Patients With an EGFR Mutation?

    abstract:UNLABELLED:We retrospectively reviewed a total of 257 stage I to IIIa lung adenocarcinoma after resection, tested them for the epidermal growth factor receptor (EGFR) mutation, and analyzed the effect of perioperative treatment on survival. The results showed that in patients with an EGFR mutation, adjuvant EGFR-tyrosi...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Lv C,An C,Feng Q,Ma Y,Li S,Wang J,Zhang J,Wang X,Yan S,Fang J,Wang Y,Tan F,Yang Y

    更新日期:2015-11-01 00:00:00

  • Radiotherapy for stage III non-small-cell lung carcinoma in the elderly (age ≥ 70 years).

    abstract:BACKGROUND:Elderly patients are underrepresented in trials that establish definitive chemoradiotherapy as the standard of care for inoperable stage III non-small-cell lung carcinoma (NSCLC). This study analyzed radiotherapy treatment delivery and outcomes at our institution according to elderly (≥ 70 years old) or youn...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Aridgides PD,Janik A,Bogart JA,Duffy S,Rosenbaum P,Gajra A

    更新日期:2013-11-01 00:00:00

  • Assessment of Selection Criteria for Low-Dose Lung Screening CT Among Asian Ethnic Groups in Taiwan: From Mass Screening to Specific Risk-Based Screening for Non-Smoker Lung Cancer.

    abstract:BACKGROUND:The National Lung Screening Trial (NLST) showed low-dose screening chest computed tomography (CT) reduced the lung cancer mortality rate up to 20% in high-risk patients in the United States. We aimed to investigate the impact of applying the NLST eligibility criteria to the population in Taiwan, and to ident...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Wu FZ,Huang YL,Wu CC,Tang EK,Chen CS,Mar GY,Yen Y,Wu MT

    更新日期:2016-09-01 00:00:00

  • Cancer treatments: can we find treasures at the bottom of the sea?

    abstract::Because of the poor results observed after platinum-based first-line chemotherapy, research on new strategies for second-line treatment of advanced non-small-cell lung cancer (NSCLC) is warranted. Current research focuses on the development of new agents and the assessment of a combination of therapies, especially tho...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Provencio M,Sánchez A,Gasent J,Gómez P,Rosell R

    更新日期:2009-07-01 00:00:00

  • Mutation of TP53 and alteration of p14(arf) expression in EGFR- and KRAS-mutated lung adenocarcinomas.

    abstract:BACKGROUND:In lung adenocarcinoma, inactivation of the tumor suppressor p53 may abrogate a safeguard mechanism preventing the development of tumors with activating mutations in EGFR or KRAS. To assess this hypothesis, we analyzed TP53 mutations and downregulation of p14(arf), a negative regulator of p53 activated by on...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Cortot AB,Younes M,Martel-Planche G,Guibert B,Isaac S,Souquet PJ,Commo F,Girard P,Fouret P,Brambilla E,Hainaut P,Soria JC

    更新日期:2014-03-01 00:00:00

  • Immune modulation as a therapeutic strategy for non-small-cell lung cancer.

    abstract::Active tumor immunotherapy may provide hope for patients with non-small-cell lung cancer (NSCLC) because, in more than 20 years, current therapies have yet to change mortality statistics. Creating an efficacious vaccine involves selection of important tumor antigens and formulation of their immunogenic epitopes into a...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Holt GE,Disis ML

    更新日期:2008-02-01 00:00:00

  • Computed tomography screening for lung cancer: applicability of an international protocol in a single-institution environment.

    abstract:BACKGROUND:The purpose of this study was to assess the applicability of an annual low-dose computed tomography (CT) screening program for lung cancer in a single institution in Israel, which has a relatively lower prevalence of lung cancer compared with other Western countries, and to examine stage distribution of dete...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Shaham D,Breuer R,Copel L,Agid R,Makori A,Kisselgoff D,Goitein O,Izhar U,Berkman N,Heching N,Sosna J,Bar-Ziv J,Libson E

    更新日期:2006-01-01 00:00:00

  • ERCC1, MLH1, MSH2, MSH6, and βIII-tubulin: resistance proteins associated with response and outcome to platinum-based chemotherapy in malignant pleural mesothelioma.

    abstract:INTRODUCTION:Platinum-based chemotherapy is besides the standard antifolate therapy with pemetrexed, the cornerstone for treatment of patients with malignant pleural mesothelioma (MPM), and its efficacy depends on several DNA repair enzymes. Therefore, these enzymes could be biomarkers for "tailoring" chemotherapy. Thi...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Ting S,Mairinger FD,Hager T,Welter S,Eberhardt WE,Wohlschlaeger J,Schmid KW,Christoph DC

    更新日期:2013-09-01 00:00:00

  • EGFR Testing in Advanced Non-Small-Cell Lung Cancer, A Mini-Review.

    abstract::Expert consensus guidelines have defined minimum requirements for routine testing and identification of classical epidermal growth factor (EGFR) mutations (ie, exon 19 deletions and exon 21 L858R substitution) and anaplastic lymphoma kinase (ALK) rearrangements in advanced non-small-cell lung cancers of adenocarcinoma...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章,评审


    authors: Sheikine Y,Rangachari D,McDonald DC,Huberman MS,Folch ES,VanderLaan PA,Costa DB

    更新日期:2016-11-01 00:00:00

  • Reliability of Small Biopsy Samples Compared With Resected Specimens for the Determination of Programmed Death-Ligand 1 Expression in Non--Small-Cell Lung Cancer.

    abstract:BACKGROUND:Several studies have assessed the expression of programmed death-ligand 1 (PD-L1) in resected surgical specimens of non-small-cell lung cancer (NSCLC). However, the expression of PD-L1 in smaller biopsy samples of advanced NSCLC has not been reported. PATIENTS AND METHODS:A total of 79 patients with NSCLC a...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Kitazono S,Fujiwara Y,Tsuta K,Utsumi H,Kanda S,Horinouchi H,Nokihara H,Yamamoto N,Sasada S,Watanabe S,Asamura H,Tamura T,Ohe Y

    更新日期:2015-09-01 00:00:00

  • Effect of Thoracic Radiotherapy Timing and Fractionation on Survival in Nonmetastatic Small Cell Lung Carcinoma.

    abstract:BACKGROUND:The optimal timing of thoracic radiation therapy (RT) in relation to chemotherapy is unknown in the treatment of nonmetastatic small cell lung cancer (SCLC). We analyzed the National Cancer Data Base (NCDB) to assess the effect on overall survival (OS) of RT timing with chemotherapy for patients with SCLC. ...

    journal_title:Clinical lung cancer

    pub_type: 杂志文章


    authors: Wong AT,Rineer J,Schwartz D,Becker D,Safdieh J,Osborn V,Schreiber D

    更新日期:2017-03-01 00:00:00