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Xiao Chu
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P47 - Small Cell Lung Cancer/NET - Biology / Translational (ID 234)
- Event: WCLC 2020
- Type: Posters
- Track: Small Cell Lung Cancer/NET
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P47.04 - Neuroendocrine Transformation from EGFR-wild type or TKI-naïve Non-Small Cell Lung Cancer: An Under-Recognized Phenomenon? (ID 873)
00:00 - 00:00 | Presenting Author(s): Xiao Chu
- Abstract
Introduction
Neuroendocrine carcinomas transformation (NET, e.g. small-cell lung cancer, SCLC) was generally regarded as a resistance mechanism to tyrosine kinase inhibitors (TKIs), especially in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). However, we found that patients naïve to EGFR-TKIs may also experience NEC transformation. Thus, we hypothesized that NET may not be limited in EGFR-TKI treated NSCLCs. Here we report a series of NET cases identified in our institute.
Methods
List of patients with multiple pathology reports between 2008 and 2019 were retrospectively generated, NET cases were picked and their histopathology slides were reviewed. Next generation sequencing and targeted sequencing were employed to identify genetic aberrations in the pre-NET and post-NET lesions. Patients with a history of previous malignancy or mixed histology were excluded. The epidemiologic, pathologic, and treatment characteristics were recorded and analyzed.
Results
Fourteen NET cases were registered with shared genetic aberrations between their pre-NET and post-NET lesions. Eight were TKI-naïve (57%), four of these TKI-naïve cases were EGFR-wild type (50%). Six cases received TKIs before transformation (43%), with one ALK-fusion case and five EGFR-mutant cases. Five of the TKI-treated cases never smoked (83%), while the only half of the TKI-naïve cases were never-smokers. Pre-NET histology included 12 adenocarcinoma, 1 squamous cell carcinoma and 1 NSCLC-nos. Post-NET histology included 10 SCLC, 3 LCNEC and 1 grade 2 neuroendocrine carcinoma. The median time interval from initial diagnosis to transformation diagnosis is 23 months.
Conclusion
NET occurs in NSCLC without TKI-target mutations or TKI treatments. Thus, physicians should be wary of NET in NSCLC not treated with TKIs, and perform re-biopsy when a transformation case is suspected.
