Journal
LUNG CANCER
Volume 129, Issue -, Pages 72-74Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2019.01.009
Keywords
De novo MET amplification; EGFR mutant; Dynamic monitoring; Non-small cell lung cancer
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Objective: De novo mesenchymal-epithelial transition (MET) amplification is believed to promote primary resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in the non-squamous non-small cell lung cancer (NSCLC). We sought to seek the treatment of a patient with EGFR-mutant NSCLC harboring de novo MET amplification. Materials and methods: After clinical diagnosis, tissue and plasma samples were obtained from the patient and subjected to next-generation sequencing to identify and dynamic monitor the mutations. Results: The patient was treated with gefitinib monotherapy in the beginning and experienced primary resistance to gefitinib but achieved a good response to the combination therapy of gefitinib and crizotinib. He achieved a 16.8-month progress free survival with the combination therapy. NGS of plasma circulating cell-free tumor DNA shown that L858R mutation was no longer detectable and the copy number of MET dropped when the patient got remission. Conclusions: The combination of EGFR- and MET- tyrosine kinase inhibitors may be an effective treatment for the rare mutations.
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