Clinical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy.
Department of Oncology, University of Turin, AOU San Luigi, Orbassano, Italy.
Tumori. 2024 Dec;110(6):NP5-NP10. doi: 10.1177/03008916241255485. Epub 2024 May 23.
Germline pathogenic mutations in gene are associated with a cancer predisposition syndrome known as Li Fraumeni syndrome. Albeit infrequently, non-small cell lung cancer, especially as oncogene-addicted disease, may be diagnosed in young patients with Li Fraumeni syndrome.
We report three cases of patients affected by Li Fraumeni syndrome who developed non-small cell lung cancer with or exon 20 insertions. The first patient suffered from liposarcoma and, then, brain metastases from -mutated non-small cell lung cancer: after stereotactic radiotherapy, he benefited from enrollment in a clinical trial with a -targeted therapy. The second young patient was a female with personal history of rhabdomyosarcoma, diagnosed with brain metastases from -mutated non-small cell lung cancer: enrollment in a clinical trial led to a temporary clinical benefit. The last case was a female diagnosed with breast carcinoma, ovarian granulosa cell tumor and advanced -mutated non-small cell lung cancer at a young age.
Young patients affected by oncogene-addicted non-small cell lung cancer and with a positive familial cancer history should be referred for an accurate genetic counselling to look for Li Fraumeni syndrome. The underlying molecular connection between and HER family receptor tyrosine kinases remains unclear, but an extensive molecular characterization of tumors from patients with Li Fraumeni syndrome should always be performed, to offer patients a personalized therapeutic approach.
基因中的种系致病性突变与一种称为 Li-Fraumeni 综合征的癌症易感性综合征相关。尽管不常见,但年轻的 Li-Fraumeni 综合征患者可能会被诊断出非小细胞肺癌,尤其是作为致癌基因依赖性疾病。
我们报告了三例患有 Li-Fraumeni 综合征的患者,他们患有非小细胞肺癌,具有 或 外显子 20 插入。第一位患者患有脂肪肉瘤,随后发生了由 -突变的非小细胞肺癌引起的脑转移:立体定向放疗后,他受益于参加了一项针对 -的靶向治疗的临床试验。第二位年轻患者是一名女性,曾患有横纹肌肉瘤,被诊断为 -突变的非小细胞肺癌脑转移:参加临床试验导致暂时的临床获益。最后一例是一名年轻女性,患有乳腺癌、卵巢颗粒细胞瘤和晚期 -突变的非小细胞肺癌。
患有致癌基因依赖性非小细胞肺癌且有阳性家族癌症史的年轻患者应转介进行准确的遗传咨询,以寻找 Li-Fraumeni 综合征。和 HER 家族受体酪氨酸激酶之间的潜在分子联系尚不清楚,但应始终对 Li-Fraumeni 综合征患者的肿瘤进行广泛的分子特征分析,为患者提供个性化的治疗方法。