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病例报告:表皮生长因子受体(EGFR)G719X/S768I/L861Q突变且伴有获得性间充质上皮转化因子(MET)扩增的晚期非小细胞肺癌患者的有效治疗:病例系列及文献综述

Case Report: The effective treatment of patients in advanced no-small cell lung cancer patients with EGFR G719X/S768I/L861Q and acquired MET amplification: A case series and literature review.

作者信息

Zhao Yun, Su Cuiyun, Shi Lina, Luo Wenqi, Liu Zhen, Liang Chuqiao, Wang Huilin, Ning Ruiling, Yu Qitao, Jiang Wei

机构信息

Department of Medical Oncology of Respiratory, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.

Medical Department, Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, China.

出版信息

Front Oncol. 2023 Feb 22;13:1126325. doi: 10.3389/fonc.2023.1126325. eCollection 2023.

Abstract

Preclinical cases suggest that EGFR tyrosine kinase inhibitors (TKIs) plus MET TKIs are a potential therapy for non-classical EGFR mutant lung cancers with MET amplification acquired resistance. Herein, we report for the first time the effectiveness of novel combination treatment regimens for patients with EGFR G719X/S768I/L861Q. Until the last follow-up assessment, two patients demonstrated improved survival after they switched to afatinib combined with savolitinib (PFS: 10 months) and furmonertinib combined with crizotinib (PFS: 6 months), respectively, that did not observed increased incidence and severity of adverse events. According to the findings of this study and literature review, various responses were observed from the combined therapy in NSCLC patients who harbored uncommon EGFR mutations and MET amplification. Furthermore, Next generation sequencing (NGS) leads to the discovery of uncommon of EGFR and reveals the co-mutations in NSCLC.

摘要

临床前病例表明,表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKIs)联合间质表皮转化因子(MET)TKIs是治疗具有MET扩增获得性耐药的非经典EGFR突变肺癌的一种潜在疗法。在此,我们首次报告了针对EGFR G719X/S768I/L861Q患者的新型联合治疗方案的有效性。直到最后一次随访评估,两名患者分别改用阿法替尼联合赛沃替尼(无进展生存期:10个月)和伏美替尼联合克唑替尼(无进展生存期:6个月)后生存期得到改善,且未观察到不良事件的发生率和严重程度增加。根据本研究的结果和文献综述,在携带罕见EGFR突变和MET扩增的非小细胞肺癌(NSCLC)患者中,联合治疗观察到了各种反应。此外,二代测序(NGS)导致发现罕见的EGFR并揭示了NSCLC中的共突变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc84/9992534/359ffad17ad8/fonc-13-1126325-g001.jpg

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