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病例报告:不同特征的携带METex14跳跃突变的中国非小细胞肺癌患者对替泊替尼的反应

Case report: Response to tepotinib in Chinese non-small cell lung cancer patients harboring METex14 skipping with varying features.

作者信息

Meng Yan, Zhou Weiping, Li Chenping, Zhou Xiangjie, Li Xiao, Li Liang, Fu Qiye, Huang Jue, Yue Yali, Shen Xuguang, Yang Lijing, Wang Meiqing

机构信息

Department of Oncology II, Hainan Cancer Hospital, Haikou, Hainan, China.

Department of Pharmacy, Boao Super Hospital, Qionghai, Hainan, China.

出版信息

Front Oncol. 2024 Jul 2;14:1383964. doi: 10.3389/fonc.2024.1383964. eCollection 2024.

Abstract

MET exon 14 (METex14) skipping is the most reported MET mutation in non-small cell lung cancer (NSCLC) and has been confirmed to respond to MET tyrosine kinase inhibitors (TKI) in clinical trials. While MET TKI tepotinib was recently approved for METex14 skipping NSCLC in China, real-world evidence is limited. We report our experience treating NSCLC patients referred from oncology sites across China with tepotinib in the Boao Lecheng Pilot Zone. Four patients have been prescribed the drug with a median age of 67 years (range, 61-71 years). One patient has concomitant BRAF V600E mutation, and another patient had savolitinib as first line of therapy but discontinued due to hepatotoxicity. Till the end of follow-up, four patients were all on tepotinib therapy, with a median duration of therapy of 19 months. One patient achieved partial response and three achieved stable disease. Three patients had peripheral edema, but all were mild. Our experience showed in real clinical setting, tepotinib had robust and durable clinical activity and a favorable toxicity profile in Chinese patients with METex14 skipping NSCLC. It is the first report on the effectiveness of tepotinib in a patient with both METex14 skipping and BRAF V600E mutations and successful MET inhibitor switch after MET inhibitor-induced liver injury.

摘要

MET外显子14(METex14)跳跃是在非小细胞肺癌(NSCLC)中报道最多的MET突变,并且在临床试验中已证实对MET酪氨酸激酶抑制剂(TKI)有反应。虽然MET TKI特泊替尼最近在中国被批准用于治疗METex14跳跃的NSCLC,但真实世界证据有限。我们报告了在博鳌乐城先行区用特泊替尼治疗从中国各地肿瘤科室转诊来的NSCLC患者的经验。4例患者已被处方该药,中位年龄为67岁(范围61 - 71岁)。1例患者伴有BRAF V600E突变,另1例患者曾将赛沃替尼作为一线治疗,但因肝毒性而停药。截至随访结束,4例患者均在接受特泊替尼治疗,中位治疗持续时间为19个月。1例患者达到部分缓解,3例患者病情稳定。3例患者出现外周水肿,但均为轻度。我们的经验表明,在真实临床环境中,特泊替尼对中国METex14跳跃的NSCLC患者具有强劲且持久的临床活性和良好的毒性特征。这是关于特泊替尼在1例同时具有METex14跳跃和BRAF V600E突变患者中的有效性以及在MET抑制剂引起肝损伤后成功转换MET抑制剂的首份报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66d7/11250067/605c82d3025c/fonc-14-1383964-g001.jpg

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