Watanabe et al reported changes in tumor markers when the tumor was transformed to SCLC; serum ProGRP and NSE levels were within normal limits prior to EGFR-TKI treatment, increased at the time of the repeat biopsy, and decreased following additional treatment [13] .Our case also showed similar changes in the level of NSE (Fig. 1). The gene discussed is EGFR; the disease is neoplasm.