Small Cell Transformation and T790M Mutation as Coresistance Mechanisms for First- line Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitor.

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Presentation transcript:

Small Cell Transformation and T790M Mutation as Coresistance Mechanisms for First- line Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitor (TKI) Therapy Failure Chee Shee-Chai, MMed Journal of Thoracic Oncology Volume 12, Issue 10, Pages e171-e173 (October 2017) DOI: 10.1016/j.jtho.2017.06.068 Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Serial contrasted computed tomography scan of the patient's thorax. (A) November 2015: nodule in the right upper lobe with ipsilateral pleural effusion at diagnosis. (B) February 2016: significant reduction in size of the primary tumor and complete resolution of the right pleural effusion after 3 months of gefitinib therapy. (C) May 2016: increase in size of the primary lung lesion and appearance of new lung nodules. (D) February 2017: marked increase in size of the primary tumor and recurrence of right pleural effusion prompting liquid and repeat tissue biopsies. Journal of Thoracic Oncology 2017 12, e171-e173DOI: (10.1016/j.jtho.2017.06.068) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions

Figure 2 (left) Biopsy specimen shows tumor cells infiltrating in a diffuse manner against a fibrotic background (hematoxylin and eosin stain; original magnification, ×240). (right) Higher-power view of the tumor showed dark cells with high nuclear-to-cytoplasmic ratios, nuclear molding, and frequent mitosis (hematoxylin and eosin; original magnification, ×200). Journal of Thoracic Oncology 2017 12, e171-e173DOI: (10.1016/j.jtho.2017.06.068) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions

Figure 3 Tumor cells are diffusely and strongly positive for CD56 (original magnification, ×100) (A), weakly positive for chromogranin (original magnification, ×200) (B), and positive for p63 (original magnification, ×100) (C) and show focal expression of thyroid transcription factor-1 (original magnification, ×100) (D). Journal of Thoracic Oncology 2017 12, e171-e173DOI: (10.1016/j.jtho.2017.06.068) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions