A Case of Primary Lung Adenocarcinoma With Recurrent Brain Metastasis due to Transformation to Small Cell Carcinoma During Adjuvant Atezolizumab Therapy
Histologic transformation from non-small cell to small cell lung cancer (SCLC) is a resistance mechanism to immune checkpoint inhibitors. We report herein a case of lung adenocarcinoma who developed liver and brain metastases during adjuvant atezolizumab therapy. The patient underwent a craniotomy to resect a brain metastasis, which was pathologically diagnosed as SCLC. He subsequently received platinum-based chemotherapy with durvalumab, resulting in sustained regression of the liver metastases. This case demonstrates a metastatic brain tumor-acquired resistance to atezolizumab through histologic transformation from adenocarcinoma to SCLC. Therefore, rebiopsy is needed if recurrent disease appears during immune checkpoint inhibitor treatment in patients with non-small cell lung cancer.
Authors
- Tomomi Masuda (ORCID: https://orcid.org/0000-0003-1573-6742)
- Rei Yamaguchi (ORCID: https://orcid.org/0000-0002-8669-3113)
- Sohei Muto (ORCID: https://orcid.org/0000-0001-8019-7912)
- Hayato Ikota
- Noriaki Sunaga (ORCID: https://orcid.org/0000-0002-5966-4579)
- Nobuteru Kubo (ORCID: https://orcid.org/0000-0002-0626-8142)
- Yasuhiko Koga (ORCID: https://orcid.org/0000-0002-4974-9026)
- Toshiteru Nagashima
- Hiroaki Tsurumaki (ORCID: https://orcid.org/0000-0003-0837-9329)
- Nao Kobayashi (ORCID: https://orcid.org/0009-0003-5533-2918)
- Ikuo Wakamatsu
- Masakiyo Yatomi (ORCID: https://orcid.org/0000-0001-6840-515X)
- Yoichi Ohtaki (ORCID: https://orcid.org/0000-0001-5485-3234)
- Toshitaka Maeno (ORCID: https://orcid.org/0000-0002-8428-1617)
- Takeshi Hisada (ORCID: https://orcid.org/0000-0002-3862-1887)
- Yosuke Miura
- Reiko Sakurai
Institutions
- Gunma University (JP)
- Gunma University Hospital (JP)
Publication Details
- Journal
- Thoracic Cancer
- Published
- 2024-12-27
- DOI
- https://doi.org/10.1111/1759-7714.15512
- Citations
- 2
- Primary Topic
- Lung Cancer Research Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.57