Responses to crizotinib and cabozantinib in patient with lung adenocarcinoma harboring mesenchymal-epithelial transition factor exon 14 skipping mutation: A case report

Autor: Ruo-Yan Qin, Ling-Yue Zhang, Cheng-Hua Lu, Ling-Shuang Liu, Xiao-Yan Guo, Hong-Hao Xue, Hui-Yong Zhang, Xin-Bei Yuan
Rok vydání: 2020
Předmět:
Oncology
medicine.medical_specialty
Epithelial-Mesenchymal Transition
Lung Neoplasms
Cabozantinib
Pyridines
medicine.medical_treatment
MET Exon 14 Mutation
Adenocarcinoma of Lung
Antineoplastic Agents
Gene mutation
Targeted therapy
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
cabozantinib
Internal medicine
Carcinoma
Non-Small-Cell Lung

medicine
Humans
Anilides
030212 general & internal medicine
Clinical Case Report
Lung cancer
Aged
crizotinib
Crizotinib
business.industry
General Medicine
Exons
Proto-Oncogene Proteins c-met
medicine.disease
lung adenocarcinoma
MET Exon 14 Skipping Mutation
mesenchymal-epithelial transition factor exon 14 skipping mutation
Treatment Outcome
chemistry
030220 oncology & carcinogenesis
Mutation
Adenocarcinoma
Drug Therapy
Combination

Female
business
medicine.drug
Research Article
Zdroj: Medicine
ISSN: 1536-5964
Popis: Rationale: Lung cancer is a leading cause of cancer-related mortality worldwide. Currently, targeted therapy has proved highly efficient in the treatment of advanced non-small cell lung cancer (NSCLC). Mesenchymal-epithelial transition factor (MET) is considered a validated molecular target in NSCLC. Given the low incidence of MET exon 14 skipping mutation, the planning of precision treatment for patients is a clinical problem that needs to be solved. In this report, we present a MET-positive case that benefited from crizotinib and cabozantinib treatment. Patient concerns: A 77-year-old patient was diagnosed with lung adenocarcinoma in our hospital. Positron emission tomography-computed tomography (PET-CT) showed a right upper lobe mass (58 × 56 mm, SUVmax 15.6), right hilar enlarged lymph nodes, and multiple bone and left adrenal metastases (c-T3N1M1c). Diagnoses: MET exon 14 mutation (exon14, c.2888-1G>C) was examined using the lung puncture sample by next generation sequencing. Therefore, the patient was diagnosed with late-stage lung adenocarcinoma with MET exon14 skipping gene mutation. Interventions: Crizotinib was given as the first-line treatment from August 2019. Considering the resistance of crizotinib, cabozantinib was given for second-line treatment. Outcomes: Crizotinib was administered (250 mg bid) for 8 months, and her disease achieved partial regression (PR) and progression-free survival (PFS), which lasted for 8 months. The patient also reached PR after the second-line treatment with cabozantinib, and is currently under follow-up, with an overall survival (OS) of >12 months. Lessons: As MET exon 14 skipping mutation is rare in clinical practices, MET-TKIs (tyrosine kinase inhibitors) treatment can boost curative effects and improve prognosis of patients with advanced lung adenocarcinoma. This case report supports a rationale for the treatment of lung adenocarcinoma patients with a MET exon 14 skipping mutation and provides alternative treatment options for these types of NSCLC patients.
Databáze: OpenAIRE