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TumorDiagnostik & Therapie 2020; 41(03): 174-177
DOI: 10.1055/a-1120-4334
Thieme Onkologie aktuell

Nichtkleinzelliges Lungenkarzinom – doppelte Resistenzentwicklung

Non-Small Cell Lung Cancer – Development of Parallel Mechanisms of Resistance
M. Moeller
1   Klinik für Innere Medizin II, Krankenhaus Martha-Maria Halle-Dölau
,
U. Siebolts
2   Insitut für Pathologie, Universitätsklinikum Halle (Saale)
,
C. Wickenhauser
2   Insitut für Pathologie, Universitätsklinikum Halle (Saale)
,
W. Schuette
1   Klinik für Innere Medizin II, Krankenhaus Martha-Maria Halle-Dölau
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Zusammenfassung

Erworbene Resistenzen gegenüber Tyrosinkinase-Inhibitoren beim nichtkleinzelligen Lungenkarzinom entwickeln sich nach etwa 9–12 Monaten. In etwa 60 % der Fälle entstehen diese durch eine sekundäre EGFR-T790M-Resistenzmutation. In dieser Kasuistik wird der Fall einer Patientin mit einer Mutation im EGFR Exon 19 beschrieben. Es entwickeln sich unter TKI-Therapie 2 parallele Resistenzmechanismen. Zum einen eine T790M-Resistenzmutation, zum anderen die Transformation in ein kleinzelliges neuroendokrines Karzinom. Unter der Therapie mit Osimertinib sowie paralleler Chemotherapie mit Carboplatin und Etoposid konnte nach 2 Zyklen eine partielle Remission erzielt werden.

Abstract

Acquired resistances to tyrosine kinase inhibitors in nonsmall cell lung cancer develop after 9–12 months. In 60 % of the cases these resistances arise because of a secondary EGFR-T790 M resistance mutation. This report is describing the case of a patient who developed parallel two different mechanisms of resistance: A T790 M resistance mutation and a transformation into a small cell neuroendocrine cancer. Under therapy with Osimertinib and chemotherapy with carboplatin and etoposide the tumor responsed partially.



Publication History

Received: 07 December 2017

Accepted: 04 January 2018

Article published online:
01 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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