2023 World Conference on Lung Cancer (Posters)-EP13.02. Dynamic Transition of Molecular Subtypes in Relapsed Small Cell Lung Cancer Treated with Multimodal Therapy

EP13.02. Dynamic Transition of Molecular Subtypes in Relapsed Small Cell Lung Cancer Treated with Multimodal Therapy - PDF(Abstract)

Back to course

Pdf Summary

This is a case report presented at the WCLC 2023 conference on a patient with relapsed small cell lung cancer (SCLC) who underwent salvage surgery after concurrent chemoradiotherapy (CCRT). The study focuses on the dynamic transition of molecular subtypes in the patient's tumor during the course of treatment.<br /><br />The patient, a 62-year-old man with limited-disease SCLC, initially received CCRT consisting of chemotherapy and radiation. However, six months after completing the treatment, a follow-up CT scan revealed a small nodule within the radiation-induced lesion in the right upper lobe. The nodule grew in size and was found to have elevated levels of a tumor marker called ProGRP. The patient then underwent salvage surgery, which involved removing the right upper lobe and mediastinal lymph nodes.<br /><br />Histological examination of the tumor tissues obtained at initial diagnosis and from the salvage surgery showed a shift in the expression of two key transcription factors, ASCL1 and NEUROD1, which are associated with neuroendocrine differentiation in SCLC. The biopsy specimen originally had high ASCL1 expression and low NEUROD1 expression, while the surgical specimen had high expression of both transcription factors. This suggests a transition from a neuroendocrine-high to a neuroendocrine-low subtype of SCLC.<br /><br />Unfortunately, the patient experienced bone metastases shortly after the salvage surgery, highlighting the aggressiveness of the tumor. The authors speculate that the shift in NEUROD1 expression after CCRT may be associated with poor outcomes following combined modality treatment.<br /><br />In conclusion, this case report demonstrates the dynamic changes in molecular subtypes of SCLC in a patient who underwent salvage surgery. The shift in NEUROD1 expression may have important implications for treatment outcomes in relapsed SCLC.

Asset Subtitle

Kengo Yasuda

Meta Tag

Speaker Kengo Yasuda

Topic SCLC & Neuroendocrine Tumors: Case Report

Keywords

case report

WCLC 2023 conference

relapsed small cell lung cancer

salvage surgery

concurrent chemoradiotherapy

molecular subtypes

neuroendocrine differentiation

ASCL1

NEUROD1

bone metastases