Author: Daniel A. Saez, MSc, Manager, LungMATCH Navigation Program, GO2 for Lung Cancer
People with lung cancer receiving treatment may encounter acquired drug resistance—a reduction in treatment effectiveness over time. Tagrisso (osimertinib) is currently a frontline treatment for people diagnosed with non-small cell lung cancer (NSCLC) with an EGFR mutation. However, acquired resistance to Tagrisso (osimertinib) is a problem for a significant group of EGFR+ patients and can even cause transformation from non-small cell lung cancer to small cell lung cancer (tSCLC).
Understanding small cell lung cancer transformation (tSCLC)
tSCLC is a process in which a lung cancer originally diagnosed as adenocarcinoma non-small cell lung cancer (aNSCLC) changes its histology, or cell type, to small cell lung cancer (SCLC). This process is mostly reported in patients receiving Tagrisso (osimertinib) but can occur with other drugs as well. Small cell lung cancer transformation is an increasing concern because very little is known about why it happens, making the transformation hard to predict. As part of our commitment to the small cell lung cancer community, this is a key area of focus for GO2 for Lung Cancer.
Advancing tSCLC research for better outcomes
Recent research by large retrospective scale analysis has focused on possible treatment options for patients with tSCLC and possible genetic markers. It is imperative to note that much of the research into tSCLC is still in very early stages and that there is ongoing work to help bring more information forward in a largely otherwise unknown section of lung cancer. As of April 2022, treatment for patients with tSCLC has been mostly narrowed down to either a combination of Tagrisso (osimertinib) and chemotherapy, chemotherapy by itself or a clinical trial.
Research has shown that checkpoint inhibitors, a type of immunotherapy, are largely ineffective for people with tSCLC. Some genetic differences in patients with tSCLC have been identified through analysis of tumor samples, but a lot of tSCLC research is still in pre-clinical or early clinical trial stages. Many physician scientists hope that identifying genetic differentiators for this population could lead to improved treatment options.
If you’d like to discuss treatment options, including clinical trials, please contact one of our LungMATCH navigators at 800-298-2436 or support@go2.org.
[…] Studies show that tSCLC occurs most often in people whose tumors have a biomarker called EGFR and who are treated with certain drugs. tSCLC is being studied to see why this type of change happens in some people and not others. This data helps researchers learn what causes tSCLC which can lead to more treatment options. […]