There is approximately a threefold increase in the rate of MYC, MYCN or MYCL amplification in cell lines derived from treated versus untreated patients [11] and a MYC transcriptional signature is enriched in tumor biopsy and circulating tumor cell (CTC)-derived SCLC patient derived xenograft (PDX)s from patients with chemoresistant disease [12]. This evidence concerns the gene MYCN and neoplasm.