It has also been reported that patients with a triple positive mutational profile of EGFR, TP53, and RB1 had a six-times higher risk of SCLC transformation than those without TP53 and RB1, but, as noted by our cohort and other published results, this is not a requirement to undergo SCLC transformation, suggesting that other pathways, including MAPK, MET, NOTCH-1, and IGFR1, may be involved [10,12]. Here, NOTCH1 is linked to small cell lung carcinoma.