EGFR-Mutant Lung Adenocarcinoma That Transformed to Small Cell Lung Cancer
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Small Cell Lung Cancer
- Biomarkers
- EGFR exon 19 deletion
- Sex
- female
- Spread to
- brain, adrenal gland, liver, thyroid
- Treatment
- surgery, chemotherapy, targeted therapy, radiation and immunotherapy
- Outcome
- In Memory
Treatment course, step by step
- Underwent curative lung surgery in January 2019, followed by 4 cycles of pemetrexed and nedaplatin.
- After metastatic recurrence, started osimertinib and initially had resolution of brain lesions and lung nodules.
- After biopsy confirmed small-cell transformation, received thoracic radiation with etoposide and cisplatin.
- Later received irinotecan, then irinotecan with atezolizumab, followed by radiation to enlarging thyroid and adrenal metastases and brief cranial radiation after multiple brain metastases developed.
What happened, in summary
A 44-year-old woman who had never smoked underwent curative surgery for Stage I lung adenocarcinoma in January 2019. The tumor carried an EGFR exon 19 deletion. After surgery, she received 4 cycles of pemetrexed and nedaplatin chemotherapy.
In 2020, new brain abnormalities, lung nodules, and pleural disease showed that the cancer had returned as Stage IV disease. She started the EGFR-targeted drug osimertinib. The brain lesions and scattered lung nodules disappeared, although a pleural mass persisted. Later imaging showed an adrenal metastasis, and a biopsy of the pleural mass in January 2022 revealed that the cancer had transformed from adenocarcinoma into small cell lung cancer.
She then received thoracic radiation with etoposide and cisplatin, which temporarily stabilized the disease. A thyroid metastasis later appeared and was also identified as small-cell neuroendocrine cancer of pulmonary origin. Treatment continued with irinotecan and then irinotecan plus atezolizumab. Despite this, liver metastases developed and the thyroid and adrenal tumors continued to grow, leading to additional radiation. When multiple brain metastases appeared, cranial radiation was started but only 2 treatments were completed.
She died on May 11, 2023, after 52.7 months of overall survival from the original lung-cancer diagnosis, with progressive cancer and organ failure.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
How we source and attribute stories Accuracy and limitations
Collections this story belongs to
- Stage 4 Lung Cancer 384 stories
- Stage 4 EGFR Mutation Lung Cancer 74 stories
- EGFR Mutation Lung Cancer 112 stories
- Atezolizumab for Lung Cancer 18 stories
These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer