Ni QingTao, Pan Chi, Dai ShengBin, Wang Peng
Department of Oncology, Jiangsu Taizhou People's Hospital, Taizhou 225300, People's Republic of China.
Department of General Surgery, Jiangsu Taizhou People's Hospital, Taizhou 225300, People's Republic of China.
Onco Targets Ther. 2020 Apr 9;13:3039-3044. doi: 10.2147/OTT.S243988. eCollection 2020.
Advanced non-small-cell lung cancer (NSCLC) patients with EGFR exon 19 deletion often get benefits from the treatment of tyrosine kinase inhibitors (TKI). In the same way, the NSCLC patients with mesenchymal-to-epithelial transition (MET) amplification get benefits from crizotinib. The treatment becomes extremely difficult for the patients with both EGFR exon 19 deletion and MET amplification, after failure of first-line TKI. An advanced NSCLC patient with EGFR exon 19 deletion was treated with TKI. However, the disease recurred after four months. MET amplification was found after biopsy again. The patient was treated with the combination of crizotinib, while the disease recurred after eight months. The patient was treated by pembrolizumab and pemetrexed + carboplatin chemotherapy as salvage therapy. The therapeutic effect has been remarkable up to present. In conclusion, immunotherapy combined with chemotherapy could be a promising therapy for the NSCLC patients with both EGFR exon 19 deletion and MET amplification after the failure of first-line TKI treatment. Thus, further insights into the variant genes contribute to NSCLC treatment.
携带表皮生长因子受体（EGFR）第19外显子缺失的晚期非小细胞肺癌（NSCLC）患者通常能从酪氨酸激酶抑制剂（TKI）治疗中获益。同样，发生间质上皮转化（MET）扩增的NSCLC患者能从克唑替尼治疗中获益。对于一线TKI治疗失败后同时存在EGFR第19外显子缺失和MET扩增的患者，治疗变得极为困难。一名携带EGFR第19外显子缺失的晚期NSCLC患者接受了TKI治疗。然而，四个月后疾病复发。再次活检后发现MET扩增。该患者接受了克唑替尼联合治疗，但八个月后疾病再次复发。该患者接受了帕博利珠单抗以及培美曲塞+卡铂化疗作为挽救治疗。截至目前，治疗效果显著。总之，对于一线TKI治疗失败后同时存在EGFR第19外显子缺失和MET扩增的NSCLC患者而言，免疫治疗联合化疗可能成为一种有前景治疗方案。因此，对变异基因的进一步深入了解有助于NSCLC的治疗。
