Small cell lung cancer transformation during immunotherapy with nivolumab: A case report
We report a rare case of transformation of non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC), without epidermal growth factor receptor (EGFR) gene mutation, during immunotherapy treatment with nivolumab. A 75-year-old man was referred to our hospital following the observation of a...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-01-01
|
| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007117300965 |
| _version_ | 1819091941341528064 |
|---|---|
| author | Takuma Imakita Kohei Fujita, M.D, Ph.D. Osamu Kanai Tsuyoshi Terashima Tadashi Mio |
| author_facet | Takuma Imakita Kohei Fujita, M.D, Ph.D. Osamu Kanai Tsuyoshi Terashima Tadashi Mio |
| author_sort | Takuma Imakita |
| collection | DOAJ |
| description | We report a rare case of transformation of non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC), without epidermal growth factor receptor (EGFR) gene mutation, during immunotherapy treatment with nivolumab. A 75-year-old man was referred to our hospital following the observation of a 64 mm mass in a chest computed tomography (CT) scan. A transbronchial biopsy of the mass identified the pathological presence of poorly differentiated NSCLC, with no histological signs of SCLC. No mutations were identified in the EGFR gene. A clinical diagnosis of NSCLC (cT3N3M1a, stage IV) was made following a positron emission tomography (PET)–CT scan and enhanced brain magnetic resonance imaging. Docetaxel and bevacizumab were selected as the first-line chemotherapy regimen; however, after two cycles, the patient developed a gastrointestinal perforation, and discontinuation of cytotoxic chemotherapy was recommended. Owing to gradual disease progression, immunotherapy with nivolumab was selected as the second-line regimen. During the immunotherapy, the tumor continued to progress and some subcutaneous tumors emerged. Biopsy of a subcutaneous tumor revealed SCLC, with positive immunostaining for cluster of differentiation 56, synaptophysin, and thyroid transcription factor-1. Serum tumor markers of SCLC were also elevated. Based on these results, we concluded that in this case NSCLC had transformed to SCLC during immunotherapy with nivolumab. |
| first_indexed | 2024-12-21T22:47:43Z |
| format | Article |
| id | doaj.art-defad39fbaf4405a9424f0620a997eee |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-12-21T22:47:43Z |
| publishDate | 2017-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-defad39fbaf4405a9424f0620a997eee2022-12-21T18:47:40ZengElsevierRespiratory Medicine Case Reports2213-00712017-01-0121C525510.1016/j.rmcr.2017.03.019Small cell lung cancer transformation during immunotherapy with nivolumab: A case reportTakuma Imakita0Kohei Fujita, M.D, Ph.D.1Osamu Kanai2Tsuyoshi Terashima3Tadashi Mio4Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, JapanDivision of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, JapanDivision of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, JapanDivision of Clinical Pathology, National Hospital Organization Kyoto Medical Center, Kyoto, JapanDivision of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, JapanWe report a rare case of transformation of non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC), without epidermal growth factor receptor (EGFR) gene mutation, during immunotherapy treatment with nivolumab. A 75-year-old man was referred to our hospital following the observation of a 64 mm mass in a chest computed tomography (CT) scan. A transbronchial biopsy of the mass identified the pathological presence of poorly differentiated NSCLC, with no histological signs of SCLC. No mutations were identified in the EGFR gene. A clinical diagnosis of NSCLC (cT3N3M1a, stage IV) was made following a positron emission tomography (PET)–CT scan and enhanced brain magnetic resonance imaging. Docetaxel and bevacizumab were selected as the first-line chemotherapy regimen; however, after two cycles, the patient developed a gastrointestinal perforation, and discontinuation of cytotoxic chemotherapy was recommended. Owing to gradual disease progression, immunotherapy with nivolumab was selected as the second-line regimen. During the immunotherapy, the tumor continued to progress and some subcutaneous tumors emerged. Biopsy of a subcutaneous tumor revealed SCLC, with positive immunostaining for cluster of differentiation 56, synaptophysin, and thyroid transcription factor-1. Serum tumor markers of SCLC were also elevated. Based on these results, we concluded that in this case NSCLC had transformed to SCLC during immunotherapy with nivolumab.http://www.sciencedirect.com/science/article/pii/S2213007117300965NivolumabNSCLCSCLC transformationImmune checkpoint inhibitor |
| spellingShingle | Takuma Imakita Kohei Fujita, M.D, Ph.D. Osamu Kanai Tsuyoshi Terashima Tadashi Mio Small cell lung cancer transformation during immunotherapy with nivolumab: A case report Respiratory Medicine Case Reports Nivolumab NSCLC SCLC transformation Immune checkpoint inhibitor |
| title | Small cell lung cancer transformation during immunotherapy with nivolumab: A case report |
| title_full | Small cell lung cancer transformation during immunotherapy with nivolumab: A case report |
| title_fullStr | Small cell lung cancer transformation during immunotherapy with nivolumab: A case report |
| title_full_unstemmed | Small cell lung cancer transformation during immunotherapy with nivolumab: A case report |
| title_short | Small cell lung cancer transformation during immunotherapy with nivolumab: A case report |
| title_sort | small cell lung cancer transformation during immunotherapy with nivolumab a case report |
| topic | Nivolumab NSCLC SCLC transformation Immune checkpoint inhibitor |
| url | http://www.sciencedirect.com/science/article/pii/S2213007117300965 |
| work_keys_str_mv | AT takumaimakita smallcelllungcancertransformationduringimmunotherapywithnivolumabacasereport AT koheifujitamdphd smallcelllungcancertransformationduringimmunotherapywithnivolumabacasereport AT osamukanai smallcelllungcancertransformationduringimmunotherapywithnivolumabacasereport AT tsuyoshiterashima smallcelllungcancertransformationduringimmunotherapywithnivolumabacasereport AT tadashimio smallcelllungcancertransformationduringimmunotherapywithnivolumabacasereport |