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间质上皮转化外显子 14 跳跃阳性浸润性黏液性腺癌的肺:首例接受间质上皮转化-酪氨酸激酶抑制剂治疗的病例。

Mesenchymal-epithelial Transition Exon 14-skipping Mutation-positive Invasive Mucinous Adenocarcinoma of the Lung: First Case Treated with Mesenchymal-epithelial Transition-tyrosine Kinase Inhibitors.

机构信息

Department of Medicine, Hino Municipal Hospital, Japan.

Department of Diagnostic Pathology, Hino Municipal Hospital, Japan.

出版信息

Intern Med. 2024 Jun 15;63(12):1789-1795. doi: 10.2169/internalmedicine.2540-23. Epub 2023 Nov 13.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f77/11239263/ec6c09f8fb3e/1349-7235-63-1789-g001.jpg

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