Mesenchymal-epithelial Transition Exon 14-skipping Mutation-positive Invasive Mucinous Adenocarcinoma of the Lung: First Case Treated with Mesenchymal-epithelial Transition-tyrosine Kinase Inhibitors.

间充质 - 上皮转化外显子 14 跳跃突变阳性侵袭性肺粘液腺癌 ： 用间充质 - 上皮转化 - 酪氨酸激酶抑制剂治疗的第一个病例。

• 影响指数: 1.282
• 发表时间: 2024 Jun 15
• 来源期刊: Intern Med
• DOI: 10.2169/internalmedicine.2540-23
• PMID: 37952955
• 文章类型: Case Reports
• 中科院分区: Q3
• 方向: 医学
• 作者列表: Okuzumi S,Suzuki H,Morinaga S,Tamura M,Minematsu N

关键词: MET exon 14 skipping mutation; interstitial lung disease; invasive mucinous adenocarcinoma; mesenchymal-epithelial transition factor; tepotinib; tyrosine kinase inhibitors

Mesh: Humans; Female; Aged; Protein Kinase Inhibitors / therapeutic use adverse effects; Lung Neoplasms / drug therapy genetics pathology; Epithelial-Mesenchymal Transition / genetics drug effects; Exons / genetics; Mutation; Adenocarcinoma, Mucinous / genetics drug therapy pathology; Fatal Outcome; Proto-Oncogene Proteins c-met / genetics; Lung Diseases, Interstitial / genetics drug therapy diagnostic imaging; Tyrosine Kinase Inhibitors

Abstract

Mesenchymal-epithelial transition (MET) exon 14-skipping mutation (METex14) is rare in pulmonary invasive mucinous adenocarcinomas (IMAs), and the clinical impact of MET-tyrosine kinase inhibitors (TKIs) remains unknown. We herein report a 75-year-old woman with IMA harboring METex14 who was treated with the MET-TKI tepotinib. The lung tumor regressed over six months; however, the patient ultimately died of exacerbated interstitial lung disease (ILD), possibly associated with tepotinib. An autopsy revealed diffuse alveolar damage in pre-existing chronic fibrosis. We discuss how to pre-evaluate ILD deterioration risks and monitor TKI-induced lung toxicity during treatment.

摘要

间充质上皮转化（MET）外显子14-跳跃突变（METex14）在肺侵袭性黏液腺癌（IMAs）中很少见，而MET-酪氨酸激酶抑制剂(TKIs)的临床影响尚不清楚.我们在此报告一名携带METex14的IMA患者75岁，她接受了MET-TKI替泊替尼治疗。肺肿瘤消退超过六个月；然而，患者最终死于加剧的间质性肺病（ILD），可能与替泊替尼有关。尸检显示在先前存在的慢性纤维化中弥漫性肺泡损伤。我们讨论了如何在治疗期间预先评估ILD恶化风险并监测TKI引起的肺毒性。