Evidence map›Paper›PMID 34622569›Full record

ReviewThoracic cancer2021

Small cell transformation of non-small cell lung cancer under immunotherapy: Case series and literature review.

Takuma Imakita, Kohei Fujita, Osamu Kanai, Misato Okamura, Masayuki Hashimoto, Koichi Nakatani, Satoru Sawai, Tadashi Mio

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Thoracic cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
  6. Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Takuma ImakitaDivision of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.ORCID 0000-0002-1246-2339
Kohei FujitaDivision of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.ORCID 0000-0002-6902-9085
Osamu KanaiDivision of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.ORCID 0000-0003-0736-3317
Misato OkamuraDivision of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.
Masayuki HashimotoDivision of Thoracic Surgery, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.
Koichi NakataniDivision of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.
Satoru SawaiDivision of Thoracic Surgery, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.
Tadashi MioDivision of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.
Kyoto Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In advanced lung cancer treatment, immunotherapy provides durable responses in some patients. However, other patients experience progressive disease and the resistance mechanisms to immunotherapy have yet been fully elucidated. Small cell transformation of non-small cell lung cancer (NSCLC) is commonly recognized as one of the resistance mechanisms to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors in EGFR-mutant NSCLC treatment. As a resistant mechanism for immunotherapy, we report the first case of small cell transformation in 2017. Since then, eight similar cases have been reported and the concept of small cell transformation is now becoming more prevalent as a mechanism of immunotherapy resistance. In our facility, we have experienced four cases of small cell transformation after immunotherapy (including the reported case in 2017). The histology of each primary tumor was squamous cell carcinoma, large cell type neuroendocrine carcinoma, or poorly differentiated NSCLC. None had driver gene mutations. Nivolumab was administered in all four cases and atezolizumab was administered as a next line to nivolumab treatment in one case. The best response to immunotherapy was partial response or stable disease. There was a wide range of periods from the start of immunotherapy to confirmation of small cell transformation (from 2 weeks to almost 3 years). In conclusion, small cell transformation is an important resistance mechanism in cancer immunotherapy. When NSCLC progresses after immunotherapy, the possibility of small cell transformation and rebiopsy should always be encouraged, as it leads to clarification of the resistance mechanisms and frequency.

Indexed as

AgedCarcinoma, Non-Small-Cell LungCell Transformation, NeoplasticDrug Resistance, NeoplasmFemaleHumansImmunotherapyLung NeoplasmsMaleMiddle AgedMutationProtein Kinase InhibitorsSmall Cell Lung CarcinomaProtein Kinase Inhibitorsimmunotherapynon-small cell lung cancerrebiopsysmall cell transformation

Identifiers

PMID34622569
PMCPMC8590890
OpenAlexW3202895341

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.