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分子剖析:肺癌腺癌的基因组导向治疗

Molecular Profiling: Genomic-Guided Therapy for Lung Adenocarcinoma.

作者信息

Nieves Figueroa Hector A, Rodriguez Cintron William

机构信息

Department of Pulmonary and Critical Care Medicine, Veterans Affairs (VA) Caribbean Healthcare System, San Juan, PRI.

Department of Pulmonary and Critical Care Medicine, Veterans Affairs (VA) Caribbean Healthcare Systems, San Juan, PRI.

出版信息

Cureus. 2025 May 25;17(5):e84789. doi: 10.7759/cureus.84789. eCollection 2025 May.

DOI:10.7759/cureus.84789
PMID:40556992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12187040/
Abstract

Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases and is frequently diagnosed at advanced stages, leading to poor survival outcomes. Molecular analysis can identify actionable mutations, such as mesenchymal-epithelial transition (MET) exon 14 skipping mutations, which serve as therapeutic targets. Capmatinib, a selective MET tyrosine kinase inhibitor (TKI), has emerged as a promising targeted therapy for this molecular subtype. We present the case of an 83-year-old former smoker with a history of chronic obstructive pulmonary disease who was diagnosed with stage 4A metastatic lung adenocarcinoma. Molecular profiling revealed a MET exon 14 skipping mutation. The patient was initiated on capmatinib, resulting in sustained disease stability and a reduction in the lesion size over a three-year follow-up. This case highlights the clinical utility of molecular testing in NSCLC, particularly for identifying MET exon 14 alterations that guide targeted therapy. Capmatinib demonstrated durable disease control and was well tolerated, offering a viable alternative to conventional chemotherapy in an elderly patient with significant comorbidities. These findings support the integration of precision oncology into the management of advanced NSCLC and underscore the potential of MET TKIs to improve outcomes in this high-risk subgroup.

摘要

非小细胞肺癌(NSCLC)占肺癌病例的大多数,且经常在晚期被诊断出来,导致生存结果较差。分子分析可以识别可操作的突变,如间充质-上皮转化(MET)外显子14跳跃突变,这些突变可作为治疗靶点。卡马替尼,一种选择性MET酪氨酸激酶抑制剂(TKI),已成为针对这种分子亚型的一种有前景的靶向治疗药物。我们报告了一例83岁有慢性阻塞性肺疾病病史的 former smoker,被诊断为4A期转移性肺腺癌。分子谱分析显示存在MET外显子14跳跃突变。该患者开始使用卡马替尼治疗,在三年的随访中病情持续稳定,病灶大小缩小。该病例突出了分子检测在NSCLC中的临床实用性,特别是对于识别指导靶向治疗的MET外显子14改变。卡马替尼显示出持久的疾病控制效果且耐受性良好,为一名有严重合并症的老年患者提供了一种可行的替代传统化疗的方案。这些发现支持将精准肿瘤学纳入晚期NSCLC的管理中,并强调了MET TKIs改善这一高风险亚组患者预后的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ae/12187040/f8a59a05b72c/cureus-0017-00000084789-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ae/12187040/e71a03b2e610/cureus-0017-00000084789-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ae/12187040/46b92f8a8892/cureus-0017-00000084789-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ae/12187040/f8a59a05b72c/cureus-0017-00000084789-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ae/12187040/e71a03b2e610/cureus-0017-00000084789-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ae/12187040/46b92f8a8892/cureus-0017-00000084789-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ae/12187040/f8a59a05b72c/cureus-0017-00000084789-i03.jpg

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