Department of Medicine, Hino Municipal Hospital, Japan.
Department of Diagnostic Pathology, Hino Municipal Hospital, Japan.
Intern Med. 2024 Jun 15;63(12):1789-1795. doi: 10.2169/internalmedicine.2540-23. Epub 2023 Nov 13.
Mesenchymal-epithelial transition (MET) exon 14-skipping mutation (METex14) is rare in pulmonary invasive mucinous adenocarcinomas (IMAs), and the clinical impact of MET-tyrosine kinase inhibitors (TKIs) remains unknown. We herein report a 75-year-old woman with IMA harboring METex14 who was treated with the MET-TKI tepotinib. The lung tumor regressed over six months; however, the patient ultimately died of exacerbated interstitial lung disease (ILD), possibly associated with tepotinib. An autopsy revealed diffuse alveolar damage in pre-existing chronic fibrosis. We discuss how to pre-evaluate ILD deterioration risks and monitor TKI-induced lung toxicity during treatment.
间质上皮转化(MET)外显子 14 跳跃突变(METex14)在肺浸润性黏液腺癌(IMAs)中较为罕见,MET 酪氨酸激酶抑制剂(TKIs)的临床影响尚不清楚。本文报告了一例 75 岁女性肺 IMAs 合并 METex14,接受 MET-TKI 特泊替尼治疗。肺肿瘤在六个月内消退;然而,患者最终死于加重的间质性肺病(ILD),可能与特泊替尼有关。尸检显示,在先前存在的慢性纤维化中存在弥漫性肺泡损伤。我们讨论了如何在治疗前评估ILD 恶化风险和监测 TKI 诱导的肺毒性。