A Case of Primary Lung Adenocarcinoma With Recurrent Brain Metastasis Due to Transformation to Small Cell Carcinoma During Adjuvant Atezolizumab Therapy

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2024 Dec 28

PMID 39731296

Authors

Nao Kobayashi

Noriaki Sunaga

Masakiyo Yatomi

Ikuo Wakamatsu

Sohei Muto

Hayato Ikota

Rei Yamaguchi

Yoichi Ohtaki

Toshiteru Nagashima

Nobuteru Kubo

Tomomi Masuda

Yosuke Miura

Hiroaki Tsurumaki

Reiko Sakurai

Yasuhiko Koga

Takeshi Hisada

Toshitaka Maeno

Affiliations

Soon will be listed here.

Abstract

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.

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