Open Access

Squamous cell transformation and EGFR T790M mutation as acquired resistance mechanisms in a patient with lung adenocarcinoma treated with a tyrosine kinase inhibitor: A case report

  • Authors:
    • Rossella Bruno
    • Agnese Proietti
    • Greta Alì
    • Gianfranco Puppo
    • Alessandro Ribechini
    • Antonio Chella
    • Gabriella Fontanini
  • View Affiliations

  • Published online on: September 8, 2017     https://doi.org/10.3892/ol.2017.6913
  • Pages: 5947-5951
  • Copyright: © Bruno et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The present case report describes the infrequent coexistence of squamous cell transformation and the epidermal growth factor receptor (EGFR) T790M mutation as resistance mechanisms to first line treatment with tyrosine kinase inhibitors. The patient was a 44‑year‑old female, diagnosed with a primitive advanced lung adenocarcinoma with bone metastases. The tumor was positive for the EGFR exon 19 deletion, therefore the patient was treated with afatinib (40 mg/day, orally) and radiotherapy for bone lesions. After 16 months, the patient developed resistance. Cytological examination of the pleural effusion confirmed an adenocarcinoma positive for the EGFR exon 19 deletion and the T790M mutation within exon 20, while a biopsy from the upper left bronchus revealed a keratinizing squamous cell carcinoma positive for the EGFR exon 19 deletion. In addition, the EGFR mutations were concomitantly detected in circulating cell‑free tumour DNA. Due to the presence of the T790M mutation, the patient underwent osimertinib therapy (80 mg/day, orally), which resulted in a partial tumour regression at the 2‑month follow‑up, whereas the squamous lesions were treated with radiotherapy. The adenocarcinoma and squamous carcinoma components may share the same origin, according to the presence of the EGFR exon 19 deletion in both lesions. More accurate characterization of resistance mechanisms may lead to the development of improved treatment regimens.
View Figures
View References

Related Articles

Journal Cover

November-2017
Volume 14 Issue 5

Print ISSN: 1792-1074
Online ISSN:1792-1082

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
x
Spandidos Publications style
Bruno R, Proietti A, Alì G, Puppo G, Ribechini A, Chella A and Fontanini G: Squamous cell transformation and EGFR T790M mutation as acquired resistance mechanisms in a patient with lung adenocarcinoma treated with a tyrosine kinase inhibitor: A case report. Oncol Lett 14: 5947-5951, 2017
APA
Bruno, R., Proietti, A., Alì, G., Puppo, G., Ribechini, A., Chella, A., & Fontanini, G. (2017). Squamous cell transformation and EGFR T790M mutation as acquired resistance mechanisms in a patient with lung adenocarcinoma treated with a tyrosine kinase inhibitor: A case report. Oncology Letters, 14, 5947-5951. https://doi.org/10.3892/ol.2017.6913
MLA
Bruno, R., Proietti, A., Alì, G., Puppo, G., Ribechini, A., Chella, A., Fontanini, G."Squamous cell transformation and EGFR T790M mutation as acquired resistance mechanisms in a patient with lung adenocarcinoma treated with a tyrosine kinase inhibitor: A case report". Oncology Letters 14.5 (2017): 5947-5951.
Chicago
Bruno, R., Proietti, A., Alì, G., Puppo, G., Ribechini, A., Chella, A., Fontanini, G."Squamous cell transformation and EGFR T790M mutation as acquired resistance mechanisms in a patient with lung adenocarcinoma treated with a tyrosine kinase inhibitor: A case report". Oncology Letters 14, no. 5 (2017): 5947-5951. https://doi.org/10.3892/ol.2017.6913