Histological transformation of non-small cell lung cancer: Clinical analysis of nine cases

Table 1 Clinical information, pathologic features, and epidermal growth factor receptor status of nine patients showing histological transformation

Before transformation onset												Post transformation onset
Case No.	Gender, age	Smoking status	Time of initial diagnosis	Clinical stage	Tumor histology	Sample type, acquisition site	Initial treatment	EGFR mutational status	TKI	TKI line	TKI treatment time (m)	Tunor histology	NSE level	Sample type, acquisition site	EGFR mutational status	Treatment	Response and PFS (mo)
1	M, 66	Former	September, 2018	T4N3M1	ADC	Biopsy, bone	No	19del	Iconitib	I	11	SCLC	ND	Biopsy, lung	19del	CTx (etoposide/cisplatin)	1
2	F, 62	Never	2014	1	ASC	Resection, lung	Surgery, CTx	1	Iconitib	I	14	SCLC	Elevated	Biopsy, chest wall	ND	CTx (etoposide/lobaplatin)	1
3	M, 60	Former	January, 2016	T4N3M1	ADC	Biopsy, lung	CTx, RT	ND	Gefitinib	II	15	SqCC	Normal (SCC)	Biopsy, axillary lymph node	21 L858R	CTx (docetaxel/cisplatin)	PD, 2
4	M, 66	Former	January, 2014	T1N0M1	ADC	Cytology, pleural effusion	No	19del	Erlotinib	I	21	SCLC	Elevated	Biopsy, lung	19del	CTx (etoposide)	1
5	M, 57	Never	February, 2017	T4N2M1	ADC	Biopsy, lung	CTx	19del	Iconitib	II	12	LCNEC	Elevated	Biopsy, lung	19del	CTx (etoposide/cisplatin)	SD, 4
62	M, 60	Former	July, 2016	TxN0M1	ADC	Biopsy, lung	CTx, Apatinib	Wide type	Gefitinib, Osimertinib	VI	6 + 3	SCLC	Normal	Biopsy, lung	Wide type	CTx (etoposide/cisplatin)	SD, 3
7	F, 42	Never	December, 2018	TxN0M1	ADC	Biopsy, lung	No	19del → 19del, T790M	Iconitib → Osimertinib	I → II	3 + 8	SCLC	ND	Excision biopsy, supraclavicular lymph nodes	ND	CTx (etoposide/cisplatin)	1
8	F, 65	Never	May, 2019	T2N3M1	ADC	Biopsy, lung	No	19del	Gefitinib	I	16	SCLC	Elevated	Biopsy, lung	ND	CTx (etoposide/cisplatin)	SD
9	F, 31	Never	April, 2018	T4N0M1	ADC	Biopsy, lung	No	19del → 19del, T790M	Iconitib → Osimertinib	I → II	6 + 15	SCLC	Elevated	Biopsy, supraclavicular lymph node	ND	Docetaxel/anlotinib	SD

¹No available data.

²Case 6 had been treated with several kinds of chemotherapies such as pemetrexed/cisplatin, docetaxel, gemcitabine/cisplatin, and vinorelbine, and case 9 had been treated with chemotherapy and immunotherapy sequentially in clinical trial before re-biopsy. EGFR: Epidermal growth factor receptor; TKI: Tyrosine kinase inhibitor; ADC: Adenocarcinoma; ASC: Adenosquamous carcinoma; CTx: Chemotherapy; SCLC: Small cell lung cancer; M: Male; F: Female; RT: Radiotherapy; SqCC: Squamous cell carcinoma; LCNEC: Large-cell neuroendocrine carcinoma; SCC: Squamous cell carcinoma antigen; ND: Undetected; PD: Disease progression; SD: Stable disease.