在加拿大,具有罕见可操作突变的晚期非小细胞肺癌(NSCLC)患者的治疗管理在各省之间有所不同,属地,以及基于获得分子检测和资助治疗的个人中心。这些变化,随着几种新的间质上皮转化(MET)因子靶向治疗NSCLC的出现,保证为使用这些药物制定基于证据的共识建议。召集了一个加拿大专家小组来定义关键的临床问题,审查证据,讨论实践建议,并就晚期MET改变的NSCLC的治疗达成共识。小组提出的问题包括:1。如何确定最有可能从MET靶向治疗中受益的患者?2.对于具有MET外显子14跳跃突变的患者,首选的一线和后续疗法是什么?3.对于具有从头MET扩增的晚期NSCLC患者,首选的一线和后续疗法是什么?4.对于晚期表皮生长因子受体(EGFR)突变的NSCLC患者,在EGFR抑制剂上进行MET扩增的首选治疗方法是什么?5.克服对MET抑制剂的耐药性的潜在策略是什么?连同本文的共识建议,将有助于在常规实践中简化MET改变的NSCLC的管理,协助临床医生做出治疗决策,并有助于确保MET改变的NSCLC患者的最佳结局。
In Canada, the therapeutic management of patients with advanced non-small cell lung cancer (NSCLC) with rare actionable mutations differs between provinces, territories, and individual centres based on access to molecular testing and funded treatments. These variations, together with the emergence of several novel mesenchymal-epithelial transition (MET) factor-targeted therapies for the treatment of NSCLC, warrant the development of evidence-based
consensus recommendations for the use of these agents. A Canadian expert panel was convened to define key clinical questions, review evidence, discuss practice recommendations and reach
consensus on the treatment of advanced MET-altered NSCLC. Questions addressed by the panel include: 1. How should the patients most likely to benefit from MET-targeted therapies be identified? 2. What are the preferred first-line and subsequent therapies for patients with MET exon 14 skipping mutations? 3. What are the preferred first-line and subsequent therapies for advanced NSCLC patients with de novo MET amplification? 4. What is the preferred therapy for patients with advanced epidermal growth factor receptor (EGFR)-mutated NSCLC with acquired MET amplification progressing on EGFR inhibitors? 5. What are the potential strategies for overcoming resistance to MET inhibitors? Answers to these questions, along with the
consensus recommendations herein, will help streamline the management of MET-altered NSCLC in routine practice, assist clinicians in therapeutic decision-making, and help ensure optimal outcomes for NSCLC patients with MET alterations.