Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment
Introduction: SCLC is an aggressive malignancy with poor outcome. Most patients have disease recurrence despite treatments with multiple modalities. Subtyping of SCLC has been proposed recently, and novel agents targeting specific subtypes are actively being investigated. In this study, we evaluated...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364323001042 |
| _version_ | 1797676544177471488 |
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| author | Ying-Chun Lo, MD, PhD Joel Rivera-Concepcion, MD George Vasmatzis, PhD Marie-Christine Aubry, MD Konstantinos Leventakos, MD, PhD |
| author_facet | Ying-Chun Lo, MD, PhD Joel Rivera-Concepcion, MD George Vasmatzis, PhD Marie-Christine Aubry, MD Konstantinos Leventakos, MD, PhD |
| author_sort | Ying-Chun Lo, MD, PhD |
| collection | DOAJ |
| description | Introduction: SCLC is an aggressive malignancy with poor outcome. Most patients have disease recurrence despite treatments with multiple modalities. Subtyping of SCLC has been proposed recently, and novel agents targeting specific subtypes are actively being investigated. In this study, we evaluated the plasticity of subtypes in paired pre- and post-treatment samples. The aim was to understand possible subtype evolution after chemotherapy resistance that could lead to alternate targeted therapy strategies. Methods: A total of 68 samples from 32 patients with sufficient paired specimens were identified from 1998 to 2022. ASCL1, NEUROD1, and POU2F3 immunohistochemistry studies were performed on all cases, and subtyping by predominant expression was determined. Subtype comparison in each patient was performed, and expression analysis was performed on the basis of subtypes. Results: Of 32 cases, 28 (88%) had the same subtype in pre- and first post-treatment specimens. Protein expression level of subtype-specific transcription factor remained stable after chemotherapy. Two of five (40%) NEUROD1-predominant SCLC switched to ASCL1-predominant phenotype after treatment. One case had a pitfall of scoring ASCL1 on specimen with marked crushing artifacts. One case revealed the challenge of proper subtyping for samples with borderline POU2F3 expression. Conclusions: Subtype of SCLC generally remains the same after acquiring chemotherapy resistance. Plasticity was observed with rare cases switching from NEUROD1-predominant to ASC1-predominant SCLC. Resubtyping is unnecessary for the consideration of novel subtype-specific targeted agents, except cases with NEUROD1-predominant subtype. |
| first_indexed | 2024-03-11T22:30:44Z |
| format | Article |
| id | doaj.art-3d147a6b289f4e73b961f1a09509fc15 |
| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-03-11T22:30:44Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj.art-3d147a6b289f4e73b961f1a09509fc152023-09-23T05:12:45ZengElsevierJTO Clinical and Research Reports2666-36432023-09-0149100561Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic TreatmentYing-Chun Lo, MD, PhD0Joel Rivera-Concepcion, MD1George Vasmatzis, PhD2Marie-Christine Aubry, MD3Konstantinos Leventakos, MD, PhD4Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; Corresponding author. Address for correspondence: Ying-Chun Lo, MD, PhD, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street Southwest Rochester, MN 55902.Department of Medical Oncology, Mayo Clinic, Rochester, MinnesotaDepartment of Molecular Medicine, Mayo Clinic, Rochester, MinnesotaDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MinnesotaDepartment of Medical Oncology, Mayo Clinic, Rochester, MinnesotaIntroduction: SCLC is an aggressive malignancy with poor outcome. Most patients have disease recurrence despite treatments with multiple modalities. Subtyping of SCLC has been proposed recently, and novel agents targeting specific subtypes are actively being investigated. In this study, we evaluated the plasticity of subtypes in paired pre- and post-treatment samples. The aim was to understand possible subtype evolution after chemotherapy resistance that could lead to alternate targeted therapy strategies. Methods: A total of 68 samples from 32 patients with sufficient paired specimens were identified from 1998 to 2022. ASCL1, NEUROD1, and POU2F3 immunohistochemistry studies were performed on all cases, and subtyping by predominant expression was determined. Subtype comparison in each patient was performed, and expression analysis was performed on the basis of subtypes. Results: Of 32 cases, 28 (88%) had the same subtype in pre- and first post-treatment specimens. Protein expression level of subtype-specific transcription factor remained stable after chemotherapy. Two of five (40%) NEUROD1-predominant SCLC switched to ASCL1-predominant phenotype after treatment. One case had a pitfall of scoring ASCL1 on specimen with marked crushing artifacts. One case revealed the challenge of proper subtyping for samples with borderline POU2F3 expression. Conclusions: Subtype of SCLC generally remains the same after acquiring chemotherapy resistance. Plasticity was observed with rare cases switching from NEUROD1-predominant to ASC1-predominant SCLC. Resubtyping is unnecessary for the consideration of novel subtype-specific targeted agents, except cases with NEUROD1-predominant subtype.http://www.sciencedirect.com/science/article/pii/S2666364323001042Small cell lung carcinomaSubtypeTargeted therapyTreatment effect |
| spellingShingle | Ying-Chun Lo, MD, PhD Joel Rivera-Concepcion, MD George Vasmatzis, PhD Marie-Christine Aubry, MD Konstantinos Leventakos, MD, PhD Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment JTO Clinical and Research Reports Small cell lung carcinoma Subtype Targeted therapy Treatment effect |
| title | Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment |
| title_full | Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment |
| title_fullStr | Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment |
| title_full_unstemmed | Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment |
| title_short | Subtype of SCLC Is an Intrinsic and Persistent Feature Through Systemic Treatment |
| title_sort | subtype of sclc is an intrinsic and persistent feature through systemic treatment |
| topic | Small cell lung carcinoma Subtype Targeted therapy Treatment effect |
| url | http://www.sciencedirect.com/science/article/pii/S2666364323001042 |
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