title: Rapid increase of serum neuron specific enolase level and tachyphylaxis of EGFR-tyrosine kinase inhibitor indicate small cell lung cancer transformation from EGFR positive lung adenocarcinoma?
abstract: We report the case of an 80-year-old male with relapsed EGFR exon 19 deletion lung adenocarcinoma treated with EGFR-tyrosine kinase inhibitor (TKI), but with poor response and rapid increase of serum neuron specific enolase (NSE). Repeat biopsy identified pathological transformation to small cell lung cancers (SCLC) retaining the same EGFR mutation. This case highlights routine serological testing of NSE may benefit for the lung adenocarcinoma patients resistant to TKIs.
authors.affiliation: Department of Thoracic Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Li
authors.forename: Yuan
authors.initials: Y
authors.lastname: Tang
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.forename: Wen-Hao
authors.initials: WH
authors.lastname: Guo
authors.forename: Yan-Chu
authors.initials: YC
authors.lastname: Li
authors.forename: Xiao-Ke
authors.initials: XK
authors.lastname: Liu
authors.forename: Chu-Ying
authors.initials: CY
authors.lastname: Huang
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Wang
authors.forename: Yu-Quan
authors.initials: YQ
authors.lastname: Wei
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic / Q000235:genetics*; D066246:ErbB Receptors / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008297:Male; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D055752:Small Cell Lung Carcinoma / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D013618:Tachyphylaxis / Q000235:genetics*
chemical_list: D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases; D010751:Phosphopyruvate Hydratase
keywords: EGFR mutation; Neuron specific enolase; Non-small cell lung cancer; Small cell lung cancer transformation