Patients with lung adenocarcinoma (ADC) who harbor drive gene mutation will inevitably develop drug resistance after receiving targeted therapy. The common mechanisms of drug resistance include secondary mutation of driver gene, change of non-driver gene, histological transformation and epithelial mesenchymal transformation. Histological transformation includes the transformation from lung ADC to small cell lung cancer (SCLC), squamous cell carcinoma (SCC), and large cell neuroendocrine carcinoma (LCNEC) and so on. Histological transformation not only has a negative impact on the quality of patients' life, but also poses great challenges to the follow-up treatment of patients. However the mechanism of transformation is still incomplete. This article will review the research results on the mechanism of histological transformation and the selection of treatment strategies.
【中文题目：驱动基因阳性肺腺癌在靶向治疗中病理类型转化的机制与治疗策略】 【中文摘要：驱动基因阳性的肺腺癌（adenocarcinoma, ADC）患者在接受靶向治疗一段时间后将不可避免地产生耐药。常见的耐药机制包括驱动基因的二次突变、非驱动基因的变异、病理类型转化和上皮间质转化等。其中病理类型转化包括肺ADC向小细胞肺癌（small cell lung cancer, SCLC）、鳞状细胞癌（squamous cell carcinoma, SCC）和大细胞神经内分泌癌（large cell neuroendocrine carcinoma, LCNEC）等病理类型发生转化。病理类型转化在降低患者生存质量的同时也对患者的后续治疗构成巨大的挑战，但目前对其机制的认知还不全面。本文将综述病理类型转化机制的研究成果以及治疗策略的选择。】 【中文关键词：肺肿瘤；靶向治疗；耐药；病理类型转化；机制】.
Keywords: Drug resistance; Histological transformation; Lung neoplasms; Mechanism; Targeted therapy.