Table 1_Case Report: A small cell lung cancer transformed from an EGFR-mutated Adenocarcinoma demonstrated a long-term remission to anti PD-1 antibody.docx

Transformation to small cell lung cancer (SCLC) is a resistance mechanism in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) after EGFR-tyrosine kinase inhibitor (EGFR-TKI) treatment. The efficacy of immune checkpoint inhibitor (ICI) in transformed SCLC remains to be elucidated. The present case report highlights a patient whose tumor underwent transformation to SCLC after developing resistance to an EGFR-TKI treatment. The patient subsequently achieved long-term remission lasting more than 5 years through treatment with an anti-PD-1 antibody nivolumab. Generally, the efficacy of ICI is inferior in EGFR-mutated NSCLC compared to those with EGFR wild-type NSCLC. However, some cases that have transformed to SCLC may be sensitive to ICI treatment. Further investigation is necessary to determine the efficacy of ICI in cases that have undergone transformation to SCLC.

表皮生长因子受体（EGFR）突变型非小细胞肺癌（NSCLC）患者在接受EGFR酪氨酸激酶抑制剂（EGFR-TKI）治疗后，发生向小细胞肺癌（SCLC）的组织学转化是一种耐药机制。免疫检查点抑制剂（ICI）在转化型SCLC中的疗效仍有待阐明。本病例报告介绍了1例患者，其肿瘤在对EGFR-TKI治疗产生耐药后发生SCLC转化，随后通过抗PD-1抗体纳武利尤单抗（nivolumab）治疗获得了长达5年以上的长期缓解。总体而言，与EGFR野生型非小细胞肺癌患者相比，EGFR突变型非小细胞肺癌患者对免疫检查点抑制剂的疗效较差。然而，部分发生SCLC转化的病例可能对免疫检查点抑制剂治疗敏感。仍需开展进一步研究以明确免疫检查点抑制剂在SCLC转化病例中的疗效。