PDF(Pubmed)
Abstract：
Mesenchymal-epithelial transition exon 14 (METex14) skipping mutations occur in about 3%-4% of patients with non-small cell lung cancer (NSCLC). This is an aggressive subtype associated with poor prognosis. METex14 skipping is a potentially targetable mutation. Targeted therapy is a promising treatment modality for patients with advanced/metastatic METex14-mutant NSCLC. Performing systematic molecular testing to detect the driver mutation is essential for initiating targeted therapy. However, there is a lack of guidelines on molecular testing for assessing the eligibility of patients for targeted therapy. Therefore, a multidisciplinary panel consisting of experts from the Middle East, Africa, and Russia convened via a virtual advisory board meeting to provide their insights on various molecular testing techniques for the diagnosis of METex14 skipping mutation, management of patients with targeted therapies, and developing consensus recommendations for improving the processes. The expert panel emphasized performing molecular testing and liquid biopsy before treatment initiation and tissue re-biopsy for patients with failed molecular testing. Liquid biopsy was recommended as complementary to tissue biopsy for disease monitoring and prognosis. Selective MET inhibitors were recommended as the first and subsequent lines of therapy. These consensus recommendations will facilitate the management of METex14 skipping NSCLC in routine practice and warrant optimum outcomes for these patients.
摘要：
间充质-上皮转化外显子14（METex14）跳跃突变发生在约3％-4％的非小细胞肺癌（NSCLC）患者中。这是一种与不良预后相关的侵袭性亚型。METex14跳跃是一种潜在的可靶向突变。靶向治疗是晚期/转移性METex14突变型NSCLC患者的有希望的治疗方式。进行系统的分子检测以检测驱动突变对于启动靶向治疗至关重要。然而,目前缺乏评估患者是否适合接受靶向治疗的分子检测指南.因此,由中东专家组成的多学科小组，非洲,和俄罗斯通过虚拟顾问委员会会议召开会议，提供他们对METex14跳跃突变诊断的各种分子检测技术的见解，对患者进行有针对性的治疗，并制定改进流程的共识建议。专家小组强调在治疗开始前进行分子检测和液体活检，并对分子检测失败的患者进行组织重新活检。建议液体活检作为组织活检的补充，用于疾病监测和预后。选择性MET抑制剂被推荐作为第一和随后的治疗路线。这些共识建议将促进常规实践中METex14跳过NSCLC的管理，并保证这些患者的最佳结局。
