Department of Pathology, Qujing Medical Districts, 920th Hospital of the Joint Logistics Support Force of PLA, Qujing.
Department of Pathology, Fifth Affiliated Hospital of Kunming Medical University, Gejiu.
Anticancer Drugs. 2022 Jan 1;33(1):e752-e755. doi: 10.1097/CAD.0000000000001176.
No targeted therapies are approved for non-small-cell lung cancer (NSCLC) with Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation to date. Trametinib, a selective allosteric inhibitor of the MEK1/2, demonstrated debatable clinical activity in KRAS-mutant NSCLC. In this case, we present a recurrent advanced NSCLC with KRAS G12C mutation successfully treated with single-agent trametinib therapy. An 87-year-old man who underwent radiotherapy for the right lung adenocarcinoma was admitted to clinical oncology center for recurrent lesions in bilateral lungs. He was unwilling to perform second-line chemotherapy, but underwent molecular profiling and revealed the KRAS G12C mutation. The single-agent target therapy of trametinib showed clinical benefit without obvious toxicity. Furthermore, this report reviewed the previous date of the preclinical and clinical and summarized that KRAS G12C mutation may be more sensitive to the inhibition of mitogen-activated protein kinase kinase. This case advocates for routine screening of KRAS point mutations in the utility of precision medicine and suggests that treatment with trametinib in advanced NSCLC cases with KRAS G12C mutation is well tolerated and effective, especially for those very elderly or unsuitable for more aggressive chemotherapy.
迄今为止,尚无针对 KRAS 突变的非小细胞肺癌(NSCLC)的靶向治疗药物。MEK1/2 的选择性变构抑制剂曲美替尼在 KRAS 突变型 NSCLC 中具有一定的临床活性。在此,我们报告了一例 KRAS G12C 突变的复发性晚期 NSCLC 患者,该患者接受单药曲美替尼治疗获得了成功。一名 87 岁男性因右肺腺癌接受放疗,后因双肺复发性病变入住临床肿瘤中心。他不愿意接受二线化疗,但进行了分子谱分析,结果显示 KRAS G12C 突变。曲美替尼的单药靶向治疗具有临床获益,且无明显毒性。此外,本报告回顾了之前的临床前和临床数据,并总结认为 KRAS G12C 突变可能对丝裂原活化蛋白激酶激酶的抑制更为敏感。该病例提倡在精准医学中常规筛查 KRAS 点突变,并表明曲美替尼治疗 KRAS G12C 突变的晚期 NSCLC 患者具有良好的耐受性和疗效,尤其是对于那些非常高龄或不适合更积极化疗的患者。
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