Mutation tracking of a patient with EGFR-mutant lung cancer harboring de novo MET amplification: Successful treatment with gefitinib and crizotinib.
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.
['Zheng|Xuanxuan|X|', 'Zhang|Guowei|G|', 'Li|Peng|P|', 'Zhang|Mina|M|', 'Yan|Xiangtao|X|', 'Zhang|Xiaojuan|X|', 'Yang|Jinbo|J|', 'Li|Haixia|H|', 'Liu|Xiyang|X|', 'Ma|Zhiyong|Z|', 'Wang|Huijuan|H|']
D002289:Carcinoma, Non-Small-Cell Lung D045744:Cell Line, Tumor D000077547:Crizotinib D058750:Epithelial-Mesenchymal Transition D066246:ErbB Receptors D000077156:Gefitinib D006801:Humans D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D009154:Mutation D047428:Protein Kinase Inhibitors
De novo MET amplification Non-small cell lung cancer Dynamic monitoring EGFR mutant