When should a biopsy be obtained to rule out small cell transformation in a patient with stage IV NSCLC and an EGFR mutation?

How does the absence of prior EGFR TKI treatment affect the decision to obtain a biopsy?

Answer from: Medical Oncologist at Academic Institution

Histologic transformation is a well-described but poorly understood - and under-diagnosed - mechanism of resistance to TKIs. The best known is small cell transformation in EGFR mutant NSCLC but transformation, to either small cell or squamous cell, has been seen with multiple different TKIs. Biopsy...

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Medical Oncologist at Cancer Care Center
While in the ideal world, tissue biopsies are cons...

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When should a biopsy be obtained to rule out small cell transformation in a patient with stage IV NSCLC and an EGFR mutation?

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