Small-cell carcinoma with an epidermal growth factor receptor mutation in a never-smoker with gefitinib-responsive adenocarcinoma of the lung.

摘要: Activating mutations in the epidermal growth factor receptor (EGFR) gene are extremely rare small-cell lung cancer (SCLC). Here, we present a case of an EGFR-mutant gefitinib-responsive non–small-cell (NSCLC) adenocarcinoma histology occurring never-smoker followed by subsequent diagnosis metastatic SCLC carrying EGFR mutation. Although gefitinib therapy primary NSCLC resulted disease control for over 3 years, patient subsequently developed to liver. Epidermal mutation analysis revealed that exon 21 L858R activating was both original and SCLC. We hypothesize either evolved from previously diagnosed or arose common precursor. Further comparative molecular these histologically distinct tumors would be value better understand potential role pathogenesis never-smokers, selection subclone as unusual mechanism acquired resistance inhibitors NSCLC.