Léonie Ferrer1, Matteo Giaj Levra2, Marie Brevet3, Martine Antoine4, Julien Mazieres5, Giulio Rossi6, Rita Chiari7, Virginie Westeel8, Michel Poudenx9, Jacques Letreut10, Radj Gervais11, Giorgia Osman12, Nicolas Girard13, Anne Claire Toffart14, Silvia Novello15, Denis Moro-Sibilot16. 1. Thoracic Oncology unit, PTV, CHU Grenoble CS10217-38043 Grenoble cedex 9, France et INSERM U 823. 2. Thoracic Oncology unit, PTV, CHU Grenoble CS10217-38043 Grenoble cedex 9, France et INSERM U 823; Oncology Department, University of Turin, AOU San Luigi Gonzaga, Orbassano, Italy. 3. Service de pathologie Est, Hopital Louis Pradel, Lyon, France. 4. Service de pathologie, HU-Est Parisien site Tenon APHP, Paris, France. 5. Service de pneumologie Hôpital Rangueil, CHU de Toulouse, Toulouse, France. 6. Pathology Unit, Azienda della Romagna, Hospital Santa Maria delle Croci, Ravenna, Italy. 7. Oncology Unit, "Santa Maria della Misericordia" Hospital, Perugia, Italy. 8. Service de pneumologie CHU, Jean Minjoz Besançon, France. 9. Centre Antoine Lacassagne, Nice, France. 10. Service de pneumologie CH du Pays d'Aix, Aix-en-Provence, France. 11. CRLCC Francois Baclesse, Caen, France. 12. Pulmonary Oncology Unit, St. Camillo Forlanini Hospital, Rome, Italy. 13. Univ Lyon 1, Univ Lyon, Lyon, France; Institut Curie, Institut du Thorax Curie Montsouris, Paris, France. 14. Pathology Department, University of Turin, AOU San Luigi Gonzaga, Orbassano, Italy. 15. Oncology Department, University of Turin, AOU San Luigi Gonzaga, Orbassano, Italy. 16. Thoracic Oncology unit, PTV, CHU Grenoble CS10217-38043 Grenoble cedex 9, France et INSERM U 823. Electronic address: DMoro.pneumo@chu-grenoble.fr.
Abstract
INTRODUCTION: Histologic transformation from NSCLC to SCLC is a mechanism of resistance in EGFR-mutant tumors but is also occasionally observed in nonmutated NSCLC. METHODS: We performed a multicenter retrospective collection of cases presenting between 2005 and 2017. The objectives were to analyze survival data and to define epidemiologic, clinical, treatment and histomolecular characteristics at both the time of diagnosis of NSCLC and of SCLC. RESULTS: Forty-eight EGFR-mutant NSCLC and 13 non-EGFR-mutant cases were registered. Most EGFR-mutant tumors retained the same EGFR mutation after transformation. The median time to SCLC transformation was shorter in the EGFR-mutant group than in non-EFGR mutants (16 months versus 26 months (p = 0.01)). Both tumors were responsive to platinum etoposide regimens (45% partial response for the EGFR-mutant group versus 40% for non-EFGR mutants). The median overall survival rates were 28 months in the EGFR-mutant group versus 37 months in the non-EFGR-mutant group, respectively. After transformation, the median overall survival was 9 months in the non-EGFR-mutant group versus 10 months in the EGFR-mutant group. CONCLUSIONS: Transformation into SCLC seems to occur more quickly in EGFR mutated tumors; however, once the tumor is transformed its survival and response to treatment seems comparable to that of classical SCLC.
INTRODUCTION: Histologic transformation from NSCLC to SCLC is a mechanism of resistance in EGFR-mutant tumors but is also occasionally observed in nonmutated NSCLC. METHODS: We performed a multicenter retrospective collection of cases presenting between 2005 and 2017. The objectives were to analyze survival data and to define epidemiologic, clinical, treatment and histomolecular characteristics at both the time of diagnosis of NSCLC and of SCLC. RESULTS: Forty-eight EGFR-mutant NSCLC and 13 non-EGFR-mutant cases were registered. Most EGFR-mutant tumors retained the same EGFR mutation after transformation. The median time to SCLC transformation was shorter in the EGFR-mutant group than in non-EFGR mutants (16 months versus 26 months (p = 0.01)). Both tumors were responsive to platinum etoposide regimens (45% partial response for the EGFR-mutant group versus 40% for non-EFGR mutants). The median overall survival rates were 28 months in the EGFR-mutant group versus 37 months in the non-EFGR-mutant group, respectively. After transformation, the median overall survival was 9 months in the non-EGFR-mutant group versus 10 months in the EGFR-mutant group. CONCLUSIONS: Transformation into SCLC seems to occur more quickly in EGFR mutated tumors; however, once the tumor is transformed its survival and response to treatment seems comparable to that of classical SCLC.
Authors: Yusuke Inoue; Ana Nikolic; Dylan Farnsworth; Rocky Shi; Fraser D Johnson; Alvin Liu; Marc Ladanyi; Romel Somwar; Marco Gallo; William W Lockwood Journal: Elife Date: 2021-06-14 Impact factor: 8.140