Department of Hematology/Oncology, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, United States.
Department of Internal Medicine, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, United States.
Lung Cancer. 2023 Dec;186:107400. doi: 10.1016/j.lungcan.2023.107400. Epub 2023 Oct 11.
Targeted therapies have revolutionized treatment for metastatic non-small cell lung cancer (NSCLC) with oncogenic driver mutations. However, challenges arise in managing concurrent mutations and overcoming resistance. We present the case of a patient with epidermal growth factor receptor (EGFR) (L747_A750delinsP exon19 deletion) and mesenchymal-epithelial transition factor (MET) mutations (D1228H, D1228N, D1228Y, Y1230H, MET amplification) who achieved a durable response to amivantamab (14 months ongoing) after progression on multiple lines of therapy including platinum-based chemotherapy, EGFR tyrosine kinase inhibitors (TKI) and combination TKI and MET inhibitors. This case highlights the utility of longitudinal next-generation sequencing (NGS) testing to identify acquired resistance and the need for continued research into understanding mechanisms of resistance to help develop future treatment strategies.
针对有致癌驱动基因突变的转移性非小细胞肺癌（NSCLC），靶向治疗已经取得了革命性的进展。然而，在管理同时存在的突变和克服耐药性方面仍存在挑战。我们报告了一例同时存在表皮生长因子受体（EGFR）（L747_A750delinsP 外显子 19 缺失）和间质上皮转化因子（MET）突变（D1228H、D1228N、D1228Y、Y1230H、MET 扩增）的患者，在接受包括铂类化疗、EGFR 酪氨酸激酶抑制剂（TKI）和联合 TKI 和 MET 抑制剂在内的多线治疗进展后，对 amivantamab（持续 14 个月）获得了持久的缓解。这个病例突出了纵向下一代测序（NGS）检测在识别获得性耐药方面的效用，以及需要继续研究耐药机制，以帮助制定未来的治疗策略。
