Combined small cell lung carcinoma harboring <scp>ALK</scp> rearrangement: A case report and literature review

Niitsu, Takayuki; Shiroyama, Takayuki; Miyake, Kotaro; Noda, Yoshimi; Kido, Kansuke; Hara, Reina; Enomoto, Takatoshi; Amiya, Saori; Suga, Yasuhiko; Fukushima, Kiyoharu; Koyama, Shohei; Iwahori, Kota; Hirata, Haruhiko; Nagatomo, Izumi; Takeda, Yoshito; Kumanogoh, Atsushi

doi:10.1111/1759-7714.13716

Cited by 11 publications

(6 citation statements)

References 32 publications

(39 reference statements)

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“…However, clinical studies of immunotherapy combined with chemotherapy in extensive-stage C-SCLC are very limited, with only a small number of individual case reports. Niitsu et al [ 13 ] reported a case of epidermal growth factor receptor mutation-positive C-SCLC that developed intrinsic resistance to the tyrosine kinase inhibitor oximotinib; this patient subsequently received 6 cycles of dose-adjusted durvalumab in combination with etoposide and carboplatin, which showed a sustained treatment response and disease control. Dong et al [ 7 ] reported a case of C-SCLC containing three different histological components; the solid tumor masses were significantly reduced after 2 cycles of treatment with camrelizumab combined with paclitaxel and cisplatin and met the RECIST criteria for partial response, suggesting that immunochemotherapy may be a feasible regimen for the treatment of extensive-stage C-SCLC.…”

Section: Discussionmentioning

confidence: 99%

“…However, targeted therapy can also be tried in patients who have failed immunochemotherapy. Niitsu et al [ 13 ] reported a young female patient who was successfully treated with alectinib for ALK-positive C-SCLC after failure of immunochemotherapy for SCLC and cytotoxic chemotherapy for adenocarcinoma. Radiotherapy is rarely used in the treatment of C-SCLC and is often combined with other regimens.…”

Section: Discussionmentioning

confidence: 99%

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Envafolimab combined with chemotherapy in the treatment of combined small cell lung cancer: A case report

Liu¹,

Li²,

Liu³

2023

World J Clin Cases

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BACKGROUND Combined small cell lung cancer (C-SCLC) is a special subtype of small cell lung cancer that is relatively rare, aggressive, and prone to early metastasis and has a poor prognosis. Currently, there are limited studies on C-SCLC, and there is no uniform standard treatment, especially for extensive C-SCLC, which still faces great challenges. In recent years, the development and progress of immunotherapy have provided more possibilities for the treatment of C-SCLC. We used immunotherapy combined with first-line chemotherapy to treat extensive-stage C-SCLC to explore its antitumor activity and safety. CASE SUMMARY We report a case of C-SCLC that presented early with adrenal, rib, and mediastinal lymph node metastases. The patient received carboplatin and etoposide with concurrent initiation of envafolimab. After 6 cycles of chemotherapy, the lung lesion was significantly reduced, and the comprehensive efficacy evaluation showed a partial response. No serious drug-related adverse events occurred during the treatment, and the drug regimen was well tolerated. CONCLUSION Envafolimab combined with carboplatin and etoposide in the treatment of extensive-stage C-SCLC has preliminary antitumor activity and good safety and tolerability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Envafolimab combined with chemotherapy in the treatment of combined small cell lung cancer: A case report

Liu¹,

Li²,

Liu³

2023

World J Clin Cases

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“…There are also detected in C-SCLCs, which usually contain the adenocarcinoma component. 20 However, RET fusions have not been reported in C-SCLC. Herein, we present a patient with stage IV C-SCLC harboring the KIF5B-RET fusion.…”

Section: Discussionmentioning

confidence: 99%

Sustained Clinical Response to 4th-Line Therapy with Selpercatinib in RET Fusion-Positive Combined Small Cell Lung Cancer

Huang,

Dai,

Yin

et al. 2023

OTT

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Objective Combined small cell lung cancer (C-SCLC) is a relatively rare subtype of small cell lung cancer (SCLC) which combines SCLC and any component of non-small cell carcinoma (NSCLC). Patients diagnosed with C-SCLC are currently recommended to receive the same treatment as SCLC cases in the absence of clear evidence suggesting different strategies. The genomic profiling of C-SCLC is rarely studied. Herein, we report a case of extensive-stage C-SCLC harboring the KIF5B-RET fusion before first-line therapy and with persistent sensitivity to fourth-line selpercatinib treatment is reported. Materials and Methods Molecular and pathological features were evaluated using transbronchial lung biopsy, immunohistochemical (IHC) staining and next-generation sequencing (NGS). Results NGS revealed the KIF5B-RET fusion in the C-SCLC tumor. The patient had a progression-free survival (PFS) surpassing 14 months after selpercatinib treatment, with ongoing clinical response in 4th-line treatment. Conclusion This case highlights the importance of comprehensive molecular testing in C-SCLC for selecting the optimal treatment. Although RET fusion is rare in patients with C-SCLC, its identification and treatment with selective RET inhibitors may contribute to clinical benefits.

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“…According to previous studies, the likelihood of EGFR mutation in C-SCLC varies from 15% to 20% ( 8 ). Per some case studies, EGFR or ALK tyrosine kinase inhibitors may be effective ( 9 ). The patient was only tested for an EGFR mutation because of financial and healthcare concerns in this case; the results were negative for the EGFR gene.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of an Elderly Patient With Combined Small Cell Lung Cancer Receiving Anlotinib: A Case Report

2021

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Combined small-cell lung cancer (C-SCLC) is a relatively rare subtype of SCLC and is defined by the combination of SCLC and any elements of non-small-cell lung carcinoma. Anlotinib is a novel oral multitarget tyrosine kinase inhibitor that led to significant improvements in progression-free survival and overall survival in third-line therapy of advanced SCLC in the ALTER1202 study. Antiangiogenic therapy with anlotinib in C-SCLC has not previously been reported. An 80-year-old man was admitted with a 20-day history of blood-stained sputum. Chest computed tomography revealed a soft mass (45 × 43 mm) in the right upper lobe and a mediastinal lymph node and additional lung lesions in the homo lung. Pathology confirmed C-SCLC after an ultrasound-guided percutaneous puncture biopsy of the right lung tumor. The elderly patient was given anlotinib monotherapy at a dose of 10 mg/day on days 1–14 of a 21-day cycle after providing informed consent, and the outcome was assessed as continued partial response. As of the last follow-up evaluation, the patient’s progression-free survival was more than 7 months, and the treatment showed satisfactory safety. Our findings provide direct evidence of the efficacy of anlotinib in an elderly patient with C-SCLC. More studies are needed to confirm our observations.

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Combined small cell lung carcinoma harboring ALK rearrangement: A case report and literature review

Cited by 11 publications

References 32 publications

Envafolimab combined with chemotherapy in the treatment of combined small cell lung cancer: A case report

Envafolimab combined with chemotherapy in the treatment of combined small cell lung cancer: A case report

Sustained Clinical Response to 4th-Line Therapy with Selpercatinib in RET Fusion-Positive Combined Small Cell Lung Cancer

Successful Treatment of an Elderly Patient With Combined Small Cell Lung Cancer Receiving Anlotinib: A Case Report

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