Transformed SCLC in EGFR‑Mutant NSCLC: Critical Progress in a High‑Risk Setting
In patients with EGFR‑mutated NSCLC who develop small‑cell transformation, EGFR‑TKI plus etoposide‑platinum chemotherapy provides the longest first‑line progression‑free survival, whereas immune‑checkpoint immunotherapy and chemotherapy alone have inferior efficacy.
Histologic transformation from lung adenocarcinoma to small‑cell lung cancer remains one of the most aggressive and difficult‑to‑treat mechanisms of resistance in EGFR‑mutated non‑small cell lung cancer. New multicenter data now provide a more detailed picture of who is at risk, how these tumors evolve genomically, and which treatments may retain activity after transformation.
Small‑cell transformation introduces a major shift in tumor biology, reducing dependence on EGFR signaling and making standard EGFR‑TKI therapy less effective. Understanding the genomic drivers and therapeutic responses in this setting is essential for guiding treatment decisions and improving patient outcomes.
Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.
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