Small cell transformation in crizotinib‐resistant <scp>ROS1</scp>‐rearranged non‐small cell lung cancer with retention of <scp>ROS1</scp> fusion: A case report

Wu, Chi‐Hao; Su, Po‐Lan; Hsu, Ching‐Wei; Chu, Chang-Yao; Lin, Chien‐Chung

doi:10.1111/1759-7714.14175

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…For example, several reports have shown HTs after treatment with ROS1-TKIs or Kirsten rat sarcoma viral oncogene homolog (KRAS) G12C-inhibitors. [61][62][63] In the case of ROS1 rearrangement-positive NSCLC, the whole exome analysis of biopsy and autopsy-derived specimens before and after crizotinib administration have provided detailed confirmation that the SCLC transformation occurred as a mechanism of resistance. 61 This case showed a loss of function of TP53 and Rb1, which was similar to typical HT cases.…”

Section: Anaplastic Lymphoma Kinase-tkismentioning

confidence: 99%

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Histologic transformation in lung cancer: when one door shuts, another opens

2022

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Histologic transformation (HT) is a major cause of drug resistance to therapy in patients with lung cancer. HTs to small-cell lung cancer (SCLC) have been reported frequently in patients with epidermal growth factor receptor ( EGFR)-mutated lung cancer. Although HTs have an impact on the clinical outcomes in patients owing to a high refractoriness to treatments, there is limited data on the prevalence, causes, mechanisms, treatment efficacy, and future treatment strategies. In this review, we assess the literature regarding HTs comprehensively, including those describing EGFR-tyrosine kinase inhibitors, other molecular targeted drugs, and immune checkpoint inhibitors. Furthermore, we discuss the mechanisms of HTs and the lineage plasticity to SCLC and squamous cell carcinoma in lung cancer. In addition, we summarize the treatment efficacy and future perspectives of HTs in patients with lung cancer, and propose better management strategies for this group of patients.

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Section: Anaplastic Lymphoma Kinase-tkismentioning

confidence: 99%

“…For example, several reports have shown HTs after treatment with ROS1-TKIs or Kirsten rat sarcoma viral oncogene homolog (KRAS) G12C-inhibitors. 61 – 63 …”

Section: Ht Induced By Agents Other Than Egfr-tkismentioning

confidence: 99%

Histologic transformation in lung cancer: when one door shuts, another opens

2022

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“…These authors estimated a frequency of SCLC transformation in 2% of ROS1-positive NSCLCs [68]. A second study reported the SCLC transformation in an ROS1-positive NSCLC patient developing crizotinib resistance after 8 months of treatment; SCLC transformation was observed at the level of a mediastinal lymph node and was associated with retention of ROS1 rearrangement [69].…”

Section: Off-target Activation Of Signaling Pathwaysmentioning

confidence: 99%

ROS1-Rearranged Lung Adenocarcinoma: From Molecular Genetics to Target Therapy

Testa,

Castelli,

Pelosi

2023

Onco

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Non-small-cell lung cancer (NSCLC) is a heterogeneous group of diseases accounting for 80–85% of lung cancers. A molecular subset of NSCLC (1–2.5%) harboring molecular rearrangements of the tyrosine kinase gene ROS1 is defined as ROS1-positive and is almost exclusively diagnosed in patients with lung adenocarcinoma histology, predominantly nonsmokers. ROS1 is constitutively activated by molecular rearrangements and acts as a main driver of lung carcinogenesis. These findings have provided a strong rationale for the clinical use of tyrosine kinase inhibitors that target ROS1; these inhibitors block ROS1-positive NSCLC and provide clinical benefit. Crizotinib was introduced as a first-line treatment for ROS1-positive NSCLCs, with 75–80% of patients responding and a PFS of about 20 months. More recently developed ROS1-TKIs, such as entrectinib, lorlatinib, taletrectinib, repotrectinib and NVL-520, are active against some resistant ROS1 mutants appearing during crizotinib therapy and more active against brain metastases, frequent in ROS1-positive NSCLC. The development of resistance mechanisms represents a great limitation for the targeted treatment of ROS1-positive NSCLCs with TKIs.

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Antineoplastics

2022

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Small cell transformation in crizotinib‐resistant ROS1‐rearranged non‐small cell lung cancer with retention of ROS1 fusion: A case report

Cited by 5 publications

References 12 publications

Histologic transformation in lung cancer: when one door shuts, another opens

Histologic transformation in lung cancer: when one door shuts, another opens

ROS1-Rearranged Lung Adenocarcinoma: From Molecular Genetics to Target Therapy

Antineoplastics

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