Table 1. Summary of cases of SCLC transformed from ALK-positive NSCLC.
| Patient No. | Sex | Age, year | Origin | CNS metastasis* | Prior treatment | ALK rearrangement remained in transformed SCLC | Subsequent SCLC therapy |
|---|---|---|---|---|---|---|---|
| Patient 1# (7) | Male | 35 | US | Yes | First-line: ceritinib; second-line: alectinib; third-line: lorlatinib | Yes | Fourth-line: carboplatin/etoposide; fifth-line: alectinib |
| Patient 2# (8) | Female | 73 | US | No | Wedge resection; first-line: carboplatin/pemetrexed | Yes | Second-line: carboplatin + etoposide; third-line: alectinib |
| Patient 3# (9) | Male | 41 | Japan | No | First-line: cisplatin plus pemetrexed; second-line: S-1; third-line: amrubicin; fourth-line: docetaxel; fifth-line: alectinib | Yes | Sixth-line: cisplatin plus irinotecan; seventh-line: amrubicin |
| Patient 4# (10) | Male | 62 | Japan | No | First-line: carboplatin, pemetrexed, and bevacizumab, alectinib; second-line: radiotherapy + alectinib | Yes | Third-line: alectinib, ceritinib; Fourth-line: cisplatin + etoposide Fifth-line and posterior-line: amrubicin, nivolumab, and irinotecan |
| Patient 5# (11) | Female | 67 | Japan | Yes | Cisplatin + vinorelbine + radiation, Radiotherapy + paclitaxel + bevacizumab, crizotinib; multiple lines: pemetrexed, gemcitabine, docetaxel, alectinib |
Yes | Irinotecan and alectinib |
| Our case | Male | 77 | China | Yes | First-line: alectinib; second-line: radiotherapy | Yes | Third-line: atezolizumab+ etoposide + carboplatin |
*, at the time of diagnosis. ALK, anaplastic lymphoma kinase; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer; CNS, central nervous system.