Response to icotinib plus chemotherapy in pulmonary atypical carcinoid harboring the EGFR L858R mutation: a brief report

Abstract Introduction Pulmonary atypical carcinoid (PAC) is a rare subtype of pulmonary neuroendocrine neoplasm. Although EML4-ALK fusion has been detected in PAC, EGFR mutations have not been reported before. Methods We performed hematoxylin and eosin staining, immunohistochemistry and next-generation sequencing on tissues at baseline and after surgery. Results The patient was diagnosed with advanced PAC harboring the EGFR L858R mutation and then received a combination of icotinib and irinotecan/cisplatin (IP) chemotherapy, achieving a partial response before the operation. Postoperative histology revealed small cell lung cancer harboring the EGFR L858R mutation. Surprisingly, both the KRAS amplification and the RB1 deletion disappeared. Conclusions EGFR tyrosine inhibitors plus IP chemotherapy might be a potential treatment option for advanced pulmonary neuroendocrine neoplasms harboring EGFR mutations.