Secondary biopsy of non-oncogenic-driven lung cancer may reveal a clinically sensible histologic change. A brief report of two paradigmatic cases

Maria Cecilia Mengoli, Giulia Orsi, Filippo Lococo, Giulia Grizzi, Fausto Barbieri, Federica Bertolini, Giulio Rossi, Silvia Novello

Research output: Contribution to journalArticle

Abstract

After an initial benefit, non-small-cell lung cancer (NSCLC) patients receiving therapy with tyrosine kinase inhibitors develop drug resistance through a variety of mechanisms. Among these, tumor histology changes are a mechanism of acquired resistance in epidermal growth factor receptor-mutated and anaplastic lymphoma kinase-rearranged NSCLC cases. The current availability of therapeutic approaches to overcome tyrosine kinase inhibitor resistance in oncogenic-driven lung cancers justifies secondary tumor biopsy in these patients. On the other hand, little is known about the mechanism of disease progression in non-oncogenic driven NSCLC. Nevertheless, NSCLC lacking "druggable" genetic alterations are not considered for secondary biopsy, as it is commonly believed that these tumors cannot develop histologic or molecular changes. Herein, we report two paradigmatic cases of wild-type NSCLC showing histologic "change" on secondary biopsy, allowing for a successful switch in therapeutic strategy.

Original languageEnglish
JournalThoracic Cancer
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Non-Small Cell Lung Carcinoma
Lung Neoplasms
Biopsy
Protein-Tyrosine Kinases
Neoplasms
Epidermal Growth Factor Receptor
Drug Resistance
Disease Progression
Histology
Therapeutics

Keywords

  • NSE
  • CEA
  • Histological change
  • Lung cancer
  • Wild-type

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Secondary biopsy of non-oncogenic-driven lung cancer may reveal a clinically sensible histologic change. A brief report of two paradigmatic cases. / Mengoli, Maria Cecilia; Orsi, Giulia; Lococo, Filippo; Grizzi, Giulia; Barbieri, Fausto; Bertolini, Federica; Rossi, Giulio; Novello, Silvia.

In: Thoracic Cancer, 2017.

Research output: Contribution to journalArticle

@article{6e1d85e5fe264618b8b7591da155f163,
title = "Secondary biopsy of non-oncogenic-driven lung cancer may reveal a clinically sensible histologic change. A brief report of two paradigmatic cases",
abstract = "After an initial benefit, non-small-cell lung cancer (NSCLC) patients receiving therapy with tyrosine kinase inhibitors develop drug resistance through a variety of mechanisms. Among these, tumor histology changes are a mechanism of acquired resistance in epidermal growth factor receptor-mutated and anaplastic lymphoma kinase-rearranged NSCLC cases. The current availability of therapeutic approaches to overcome tyrosine kinase inhibitor resistance in oncogenic-driven lung cancers justifies secondary tumor biopsy in these patients. On the other hand, little is known about the mechanism of disease progression in non-oncogenic driven NSCLC. Nevertheless, NSCLC lacking {"}druggable{"} genetic alterations are not considered for secondary biopsy, as it is commonly believed that these tumors cannot develop histologic or molecular changes. Herein, we report two paradigmatic cases of wild-type NSCLC showing histologic {"}change{"} on secondary biopsy, allowing for a successful switch in therapeutic strategy.",
keywords = "NSE, CEA, Histological change, Lung cancer, Wild-type",
author = "Mengoli, {Maria Cecilia} and Giulia Orsi and Filippo Lococo and Giulia Grizzi and Fausto Barbieri and Federica Bertolini and Giulio Rossi and Silvia Novello",
year = "2017",
doi = "10.1111/1759-7714.12416",
language = "English",
journal = "Thoracic Cancer",
issn = "1759-7706",
publisher = "Blackwell Publishing Asia Pty Ltd",

}

TY - JOUR

T1 - Secondary biopsy of non-oncogenic-driven lung cancer may reveal a clinically sensible histologic change. A brief report of two paradigmatic cases

AU - Mengoli, Maria Cecilia

AU - Orsi, Giulia

AU - Lococo, Filippo

AU - Grizzi, Giulia

AU - Barbieri, Fausto

AU - Bertolini, Federica

AU - Rossi, Giulio

AU - Novello, Silvia

PY - 2017

Y1 - 2017

N2 - After an initial benefit, non-small-cell lung cancer (NSCLC) patients receiving therapy with tyrosine kinase inhibitors develop drug resistance through a variety of mechanisms. Among these, tumor histology changes are a mechanism of acquired resistance in epidermal growth factor receptor-mutated and anaplastic lymphoma kinase-rearranged NSCLC cases. The current availability of therapeutic approaches to overcome tyrosine kinase inhibitor resistance in oncogenic-driven lung cancers justifies secondary tumor biopsy in these patients. On the other hand, little is known about the mechanism of disease progression in non-oncogenic driven NSCLC. Nevertheless, NSCLC lacking "druggable" genetic alterations are not considered for secondary biopsy, as it is commonly believed that these tumors cannot develop histologic or molecular changes. Herein, we report two paradigmatic cases of wild-type NSCLC showing histologic "change" on secondary biopsy, allowing for a successful switch in therapeutic strategy.

AB - After an initial benefit, non-small-cell lung cancer (NSCLC) patients receiving therapy with tyrosine kinase inhibitors develop drug resistance through a variety of mechanisms. Among these, tumor histology changes are a mechanism of acquired resistance in epidermal growth factor receptor-mutated and anaplastic lymphoma kinase-rearranged NSCLC cases. The current availability of therapeutic approaches to overcome tyrosine kinase inhibitor resistance in oncogenic-driven lung cancers justifies secondary tumor biopsy in these patients. On the other hand, little is known about the mechanism of disease progression in non-oncogenic driven NSCLC. Nevertheless, NSCLC lacking "druggable" genetic alterations are not considered for secondary biopsy, as it is commonly believed that these tumors cannot develop histologic or molecular changes. Herein, we report two paradigmatic cases of wild-type NSCLC showing histologic "change" on secondary biopsy, allowing for a successful switch in therapeutic strategy.

KW - NSE

KW - CEA

KW - Histological change

KW - Lung cancer

KW - Wild-type

UR - http://www.scopus.com/inward/record.url?scp=85017396211&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017396211&partnerID=8YFLogxK

U2 - 10.1111/1759-7714.12416

DO - 10.1111/1759-7714.12416

M3 - Article

AN - SCOPUS:85017396211

JO - Thoracic Cancer

JF - Thoracic Cancer

SN - 1759-7706

ER -