Rapid increase of serum neuron specific enolase level and tachyphylaxis of EGFR-tyrosine kinase inhibitor indicate small cell lung cancer transformation from EGFR positive lung adenocarcinoma?

Lung Cancer. 2013 Aug;81(2):302-5. doi: 10.1016/j.lungcan.2013.04.005. Epub 2013 May 15.

Abstract

We report the case of an 80-year-old male with relapsed EGFR exon 19 deletion lung adenocarcinoma treated with EGFR-tyrosine kinase inhibitor (TKI), but with poor response and rapid increase of serum neuron specific enolase (NSE). Repeat biopsy identified pathological transformation to small cell lung cancers (SCLC) retaining the same EGFR mutation. This case highlights routine serological testing of NSE may benefit for the lung adenocarcinoma patients resistant to TKIs.

Keywords: EGFR mutation; Neuron specific enolase; Non-small cell lung cancer; Small cell lung cancer transformation.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology*
  • Adenocarcinoma of Lung
  • Aged, 80 and over
  • Cell Transformation, Neoplastic / genetics*
  • ErbB Receptors / genetics*
  • Humans
  • Lung Neoplasms / blood
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology*
  • Male
  • Phosphopyruvate Hydratase / blood*
  • Protein Kinase Inhibitors / therapeutic use
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Small Cell Lung Carcinoma / blood
  • Small Cell Lung Carcinoma / drug therapy
  • Small Cell Lung Carcinoma / genetics
  • Small Cell Lung Carcinoma / pathology*
  • Tachyphylaxis / genetics*

Substances

  • Protein Kinase Inhibitors
  • EGFR protein, human
  • ErbB Receptors
  • Protein-Tyrosine Kinases
  • Phosphopyruvate Hydratase