Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Thorac Cancer. 2024 Nov;15(32):2339-2343. doi: 10.1111/1759-7714.15459. Epub 2024 Sep 29.
Mesenchymal-epithelial transition (MET) exon 14 (METex14) skipping mutation is a rare (3%-4%) driver mutation in non-small cell lung cancer (NSCLC). Tepotinib, a selective MET inhibitor, has shown promise in treating METex14 skipping-mutated NSCLC. However, its feasibility for perioperative application remains unclear. This report describes a 60-year-old man with stage IIIA (cT2N2M0) lung adenocarcinoma harboring a METex14 skipping mutation. After initial treatment with savolitinib was discontinued due to grade 4 transaminitis, the patient was switched to tepotinib, resulting in significant tumor regression. Six months later, further shrinkage was observed, and surgery revealed remarkable pathological response with no residual tumor in lymph nodes (ypT2N0M0, IB). Postoperative tepotinib continued, with no relapse at 6-month follow-up. This case highlights the potential of tepotinib as neoadjuvant therapy for resectable METex14 skipping-mutated NSCLC, warranting further clinical trials.
间质上皮转化（MET）外显子 14（METex14）跳跃突变是一种非小细胞肺癌（NSCLC）中罕见的（3%-4%）驱动突变。Tepotinib 是一种选择性 MET 抑制剂，在治疗 METex14 跳跃突变型 NSCLC 方面显示出前景。然而，其在围手术期应用的可行性尚不清楚。本报告描述了一名 60 岁男性，患有 IIIA 期（cT2N2M0）肺腺癌，携带 METex14 跳跃突变。由于 4 级转氨基酶升高，初始治疗停止使用 savolitinib 后，患者改用 tepotinib，导致肿瘤显著缩小。6 个月后，进一步缩小，手术显示淋巴结（ypT2N0M0，IB）无残留肿瘤的显著病理反应。术后继续 tepotinib 治疗，6 个月随访时无复发。该病例强调了 tepotinib 作为可切除 METex14 跳跃突变型 NSCLC 新辅助治疗的潜力，值得进一步的临床试验。
