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治疗难治性 NSCLC 中携带 EGFR 和复杂 MET 突变患者的持久反应:一例报告。

Durable response to amivantamab in treatment refractory NSCLC harboring EGFR and complex MET mutations: A case report.

机构信息

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.

出版信息

Lung Cancer. 2023 Dec;186:107400. doi: 10.1016/j.lungcan.2023.107400. Epub 2023 Oct 11.

Abstract

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.

摘要

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。

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