There is still a role for cytology in the 'liquid biopsy' era. A lesson from a TKI-treated patient showing adenocarcinoma to squamous cell carcinoma transition during disease progression
| Autor: | Pasquale Pisapia, Giancarlo Troncone, Umberto Malapelle, Antonio Marano, Salvatore Feliciano, Claudio Bellevicine, Elena Vigliar, Eduardo Clery, Caterina De Luca |
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| Přispěvatelé: | Clery, Eduardo, Pisapia, Pasquale, Feliciano, Salvatore, Vigliar, Elena, Marano, Antonio, DE LUCA, Caterina, Malapelle, Umberto, Troncone, Giancarlo, Bellevicine, Claudio |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pathology Lung Neoplasms Time Factors Biopsy DNA Mutational Analysis CYTOLOGY 0302 clinical medicine Cytology Carcinoma Non-Small-Cell Lung Epidermal growth factor receptor Molecular Targeted Therapy MOLECULAR PATHOLOGY Ultrasonography medicine.diagnostic_test biology Molecular pathology General Medicine ErbB Receptors Treatment Outcome 030220 oncology & carcinogenesis Carcinoma Squamous Cell Disease Progression Adenocarcinoma Female medicine.medical_specialty Class I Phosphatidylinositol 3-Kinases EGFR Adenocarcinoma of Lung Antineoplastic Agents Pathology and Forensic Medicine 03 medical and health sciences Predictive Value of Tests Carcinoma medicine Biomarkers Tumor Humans Liquid biopsy Lung cancer Protein Kinase Inhibitors Aged business.industry LUNG CANCER medicine.disease respiratory tract diseases 030104 developmental biology Drug Resistance Neoplasm Cancer research biology.protein MORPHOLOGY business Tomography X-Ray Computed |
| Zdroj: | Journal of clinical pathology. 70(9) |
| ISSN: | 1472-4146 |
| Popis: | Non-small cell lung carcinoma harbouring epidermal growth factor receptor (EGFR) mutation, usually progress after an initial response to tyrosine-kinase inhibitors (TKI). Liquid biopsy enables with a simple blood draw the accurate detection ofEGFRp.T790M mutation, the most common resistance mechanism, avoiding the more invasive tissue re-biopsy. However, in a subset of cases, resistance mechanisms are more complex featuring both genetic and morphological changes. Here we report the case of a 67 years-old woman, affected by anEGFRmutated lung adenocarcinoma and treated by TKI. At disease progression, the patient developed a morphological transition to squamous cell carcinoma in association to the arising of aPIK3CAp.E542K mutant subclone. This case illustrates that, even in the “liquid biopsy” era, cytology can have still a role by providing an overall assessment of both morphology and genetic TKI resistance mechanisms. |
| Databáze: | OpenAIRE |
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