Department of Cancer Medicine, Gustave Roussy, Villejuif, France.
Department of Respiratory Medicine, Maastricht University Medical Centre, GROW School for Oncology and Reproduction, Maastricht, the Netherlands.
J Thorac Oncol. 2023 Apr;18(4):419-435. doi: 10.1016/j.jtho.2022.10.015. Epub 2022 Oct 29.
Targeted therapies have revolutionized the treatment and improved the outcome for oncogene-driven NSCLC and an increasing number of oncogenic driver therapies have become available. For MET-dysregulated NSCLC (especially MET exon 14 skipping mutations and MET-amplifications, which is one of the most common bypass mechanisms of resistance in oncogene-addicted NSCLC), several anti-MET-targeted therapies have been approved recently (MET exon 14 skipping mutation) and multiple others are in development. In this narrative review, we summarize the role of MET as an oncogenic driver in NSCLC, discuss the different testing methods for exon 14 skipping mutations, gene amplification, and protein overexpression, and review the existing data and ongoing clinical trials regarding targeted therapies in MET-altered NSCLC. As immunotherapy with or without chemotherapy has become the standard of care for advanced NSCLC, immunotherapy data for MET-dysregulated NSCLC are put into perspective. Finally, we discuss future challenges in this rapidly evolving landscape.
靶向治疗已经彻底改变了癌症驱动基因阳性非小细胞肺癌的治疗方法,并改善了其预后。越来越多的致癌驱动基因治疗药物已经问世。对于 MET 失调的非小细胞肺癌(尤其是 MET 外显子 14 跳跃突变和 MET 扩增,这是致癌基因依赖性非小细胞肺癌中最常见的耐药旁路机制之一),最近已经批准了几种抗 MET 靶向治疗药物(MET 外显子 14 跳跃突变),还有许多其他药物正在开发中。在本篇综述中,我们总结了 MET 作为致癌驱动基因在非小细胞肺癌中的作用,讨论了用于外显子 14 跳跃突变、基因扩增和蛋白过表达的不同检测方法,并回顾了针对 MET 改变的非小细胞肺癌的靶向治疗的现有数据和正在进行的临床试验。由于免疫治疗联合或不联合化疗已成为晚期非小细胞肺癌的标准治疗方法,因此将 MET 失调非小细胞肺癌的免疫治疗数据纳入考虑范围。最后,我们讨论了在这个快速发展的领域中未来面临的挑战。