Shen Lan, Zhao Jikai, Yang Ying, Mu Shuya, Yu Yongfeng, Han Yuchen, Lu Shun
Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Transl Lung Cancer Res. 2024 Jun 30;13(6):1407-1413. doi: 10.21037/tlcr-24-124. Epub 2024 Jun 25.
Mesenchymal-epithelial transition () represents a potential therapeutic target in various cancers, with amplification of the gene identified in a subset of patients with pulmonary adenocarcinomas. However, gene amplification is rarely observed in high-grade fetal adenocarcinoma (H-FLAC).
Here we present a novel case of a patient diagnosed with stage IV H-FLAC harboring amplifications and treated with savolitinib. The 69-year-old male patient, who presented with a primary complaint of cough and white sputum, had a history of hypertension for over 10 years and a 45-year smoking history. The patient received savolitinib monotherapy treatment due to brain metastases. Despite the omission of radiotherapy for asymptomatic brain metastases, a notable response to savolitinib therapy was observed, with a partial response (PR) achieved after 4 weeks and a reduction in the brain tumor. At the time of the submission of this report, the patient received over 24 weeks of savolitinib treatment, and was maintained PR. The patient was still undergoing treatment. This highlights the potential clinical benefits of targeted therapy against amplification in H-FLAC.
H-FLAC harboring amplification and brain metastasis is rare. Treatment with savolitinib monotherapy resulted in a PR, providing preliminary insights to the efficacy of savolitinib for H-FLAC with amplification.
间质上皮转化（MET）是多种癌症潜在的治疗靶点，在部分肺腺癌患者中已发现MET基因扩增。然而，在高级别胎儿型腺癌（H-FLAC）中很少观察到MET基因扩增。
本文报告一例新诊断为IV期H-FLAC且存在MET扩增并接受赛沃替尼治疗的患者。该69岁男性患者以咳嗽和白色痰液为主诉，有10余年高血压病史及45年吸烟史。因脑转移，患者接受了赛沃替尼单药治疗。尽管未对无症状脑转移进行放疗，但观察到赛沃替尼治疗有显著反应，4周后达到部分缓解（PR），脑肿瘤缩小。在提交本报告时，患者接受赛沃替尼治疗已超过24周，维持PR状态。患者仍在接受治疗。这突出了针对H-FLAC中MET扩增进行靶向治疗的潜在临床益处。
伴有MET扩增和脑转移的H-FLAC罕见。赛沃替尼单药治疗产生了PR，为赛沃替尼治疗伴有MET扩增的H-FLAC的疗效提供了初步见解。
