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单一靶向 MET 在 EGFR 突变和 MET 扩增的非小细胞肺癌中的作用。

Single targeting of MET in EGFR-mutated and MET-amplified non-small cell lung cancer.

机构信息

Research Institute, National Cancer Center, Goyang, Republic of Korea.

Department of Pathology, National Cancer Center, Goyang, Republic of Korea.

出版信息

Br J Cancer. 2023 Jun;128(12):2186-2196. doi: 10.1038/s41416-023-02264-4. Epub 2023 Apr 14.

Abstract

BACKGROUND

In EGFR-mutant and MET-amplified lung cancer resistant to EGFR inhibitors, double blockade of EGFR and MET is considered as a reasonable strategy despite increasing toxicity. This study evaluated the single MET inhibition in these specific tumours.

METHODS

We investigated the efficacy of a single MET inhibitor in EGFR-mutant, MET-amplified lung cancer cells (HCC827GR) and the matched clinical cases and patient-derived cells. Acquired resistance mechanisms to single MET inhibitor were further explored.

RESULTS

Single MET inhibitor sufficiently inhibited the EGFR downstream signalling and proliferation in the HCC827GR cells. The MET-inhibitor-sensitive clones had similar EGFR mutation allele frequency as the MET-inhibitor-resistant clones. The patients with EGFR-mutant, MET-amplified lung cancer resistant to EGFR inhibitors showed definite response to single MET inhibitor but the response duration was not durable. The MET gene copy number in their plasma circulating tumour DNA was significantly decreased during the treatment and was not re-increased after progression. In the cells resistant to single MET inhibitor, the EGFR pathway was reactivated, and gefitinib alone successfully suppressed their growth.

CONCLUSIONS

Single MET inhibition produced a short-lived response in EGFR-mutant and MET-amplified lung cancer. A further study of a novel combination therapy schedule is needed to achieve long-lasting efficacy and less toxicity.

摘要

背景

在 EGFR 突变和 MET 扩增的对 EGFR 抑制剂耐药的肺癌中,尽管毒性增加,但双重阻断 EGFR 和 MET 被认为是一种合理的策略。本研究评估了在这些特定肿瘤中单用 MET 抑制剂的效果。

方法

我们研究了单 MET 抑制剂在 EGFR 突变、MET 扩增的肺癌细胞(HCC827GR)及其匹配的临床病例和患者来源细胞中的疗效。进一步探讨了对单 MET 抑制剂获得性耐药的机制。

结果

单 MET 抑制剂能充分抑制 HCC827GR 细胞中 EGFR 下游信号和增殖。对 MET 抑制剂敏感的克隆与对 MET 抑制剂耐药的克隆具有相似的 EGFR 突变等位基因频率。对 EGFR 抑制剂耐药的 EGFR 突变、MET 扩增的肺癌患者对单 MET 抑制剂有明确的反应,但反应持续时间并不持久。在治疗过程中,其血浆循环肿瘤 DNA 中的 MET 基因拷贝数显著下降,且在进展后并未再次升高。在对单 MET 抑制剂耐药的细胞中,EGFR 通路被重新激活,单用吉非替尼即可成功抑制其生长。

结论

单 MET 抑制在 EGFR 突变和 MET 扩增的肺癌中产生了短暂的反应。需要进一步研究新的联合治疗方案,以实现持久的疗效和较少的毒性。

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