III 期不可切除 MET 高拷贝数扩增伴 PD-L1 高表达非小细胞肺癌案例报道
导语:
■ III 期不可切除非小细胞肺癌患者治疗策略以根治性放化疗为主。然而在该治疗模式下,驱动基因阳性的 III 期患者治疗需求远远没有被满足。
■ 免疫治疗和靶向治疗均是非小细胞肺癌治疗重要的研究与实践方向。对于原发性 MET 高拷贝数扩增合并 PD-L1 高表达的 III 期非小细胞肺癌患者,靶向、免疫或靶免联合治疗的价值都缺乏成熟经验,MET 抑制剂联合 PD-1 抑制剂的疗效值得探索,但联合用药安全性需高度关注。本文分享一例 MET 抑制剂赛沃替尼联合 PD-1 抑制剂信迪利单抗治疗的 NSCLC 患者,旨在为临床实践提供具有参考价值的经验与启示。

内容策划:方程
项目审核:杨静
参考文献:
[1]中华医学会病理学分会,国家病理质控中心,中华医学会肿瘤学分会肺癌学组,等. 非小细胞肺癌MET临床检测中国专家共识[J]. 中华病理学杂志,2022,51(11):1094-1103.
[2]Wolf J, Seto T, Han JY, et al. Capmatinib in MET Exon 14-Mutated or MET-Amplified Non-Small-Cell Lung Cancer. N Engl J Med. 2020;383(10):944-957.
[3]Sequist LV, Han JY, Ahn MJ, et al. Osimertinib plus savolitinib in patients with EGFR mutation-positive, MET-amplified, non-small-cell lung cancer after progression on EGFR tyrosine kinase inhibitors: interim results from a multicentre, open-label, phase 1b study. Lancet Oncol. 2020;21(3):373-386.
[4]Camidge DR, Otterson GA, Clark JW, et al. Crizotinib in Patients with MET-Amplified NSCLC[J]. J. Thorac. Oncol. 2021, 16, 1017–1029.
[5]Domènech M, Muñoz Marmol AM, Mate JL, et al. Correlation between PD-L1 expression and MET gene amplification in patients with advanced non-small cell lung cancer and no other actionable oncogenic driver[J].Oncotarget. 2021 Aug 31;12(18):1802-1810.
[6]俞晓晴, 徐艳珺, 范云. c-MET 通路和抑制剂在非小细胞肺癌中的研究进展[J]. 中国肺癌杂志. 2017, 20(4): 287-292.
[7]Sauter JL, Graham RP, Larsen BT, Jenkins SM, Roden AC, Boland JM. SMARCA4-deficient thoracic sarcoma: a distinctive clinicopathological entity with undifferentiated rhabdoid morphology and aggressive behavior. Mod Pathol. 2017. 30(10): 1422-1432.
[8]Yoshida A, Kobayashi E, Kubo T, et al. Clinicopathological and molecular characterization of SMARCA4-deficient thoracic sarcomas with comparison to potentially related entities. Mod Pathol. 2017. 30(6): 797-809.
[9]Nicholson AG, Tsao MS, Beasley MB, et al. The 2021 WHO Classification of Lung Tumors: Impact of Advances Since 2015. J Thorac Oncol. 2022. 17(3): 362-387.
[10]Rekhtman N, Montecalvo J, Chang JC, et al. SMARCA4-Deficient Thoracic Sarcomatoid Tumors Represent Primarily Smoking-Related Undifferentiated Carcinomas Rather Than Primary Thoracic Sarcomas. J Thorac Oncol. 2020. 15(2): 231-247.
[11]Shi L, Lin L, Ding Y, Zeng Y, Chen X. Case report: A rapid response to immunotherapy in a thoracic SMARCA4-deficient undifferentiated tumor with respiratory failure. Front Oncol. 2022. 12: 1020875.
[12]Utsumi T, Taniguchi Y, Noda Y, Fukai M, Kibata K, Murakawa T. SMARCA4-deficient undifferentiated tumor that responded to chemotherapy in combination with immune checkpoint inhibitors: A case report. Thorac Cancer. 2022. 13(15): 2264-2266.
[13]Lin YT, Li CF, Wu HC, Jan YH, Kuo YH. Case report: Heterogenous SMARCA4-deficient thoracic non-small cell lung carcinoma with various responses to nivolumab. Front Immunol. 2023. 14: 1131448.
[14]Kawachi H, Kunimasa K, Kukita Y, et al. Atezolizumab with bevacizumab, paclitaxel and carboplatin was effective for patients with SMARCA4-deficient thoracic sarcoma. Immunotherapy. 2021. 13(10): 799-806.
[15]Spigel DR, Faivre-Finn C, Gray JE, et al. Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer [published correction appears in J Clin Oncol. 2022 Jun 10;40(17):1965.
[16]Zhou Q, Pan Y, Yang X, et al. Neoadjuvant SHR-1701 with or without chemotherapy in unresectable stage III non-small-cell lung cancer: A proof-of-concept, phase 2 trial. Cancer Cell. 2024;42(7):1258-1267.e2.
[17]Felip E, Altorki N, Zhou C, et al. Overall survival with adjuvant atezolizumab after chemotherapy in resected stage II-IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase III trial. Ann Oncol. 2023;34(10):907-919.
[18]Spicer JD, Garassino MC, Wakelee H, et al. Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab compared with neoadjuvant chemotherapy alone in patients with early-stage non-small-cell lung cancer (KEYNOTE-671): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2024;404(10459):1240-1252.
[19]Awad MM, Forde PM, Girard N, et al. Neoadjuvant Nivolumab Plus Ipilimumab Versus Chemotherapy in Resectable Lung Cancer. J Clin Oncol. Published online January 8, 2025.
[20]Liu SY, Dong S, Yang XN, et al. Neoadjuvant nivolumab with or without platinum-doublet chemotherapy based on PD-L1 expression in resectable NSCLC (CTONG1804): a multicenter open-label phase II study. Signal Transduct Target Ther. 2023;8(1):442.
[21]Lu S, Kato T, Dong X, et al. Osimertinib after Chemoradiotherapy in Stage III EGFR-Mutated NSCLC. N Engl J Med. 2024;391(7):585-597.
[22]Lu S, et al. A phase IIIb study of savolitinib in patients with locally advanced or metastatic NSCLC harboring MET exon 14 mutation. ELCC 2024. 1MO.
[23]Li R, Liu X, Xu Y, et al. Remarkable pathological response to neoadjuvant tepotinib in lung adenocarcinoma with MET exon 14 skipping mutation: A case report. Thorac Cancer. 2024;15(32):2339-2343.
[24]Chen L, Chen JF, He JT, Rong H, Zhuang X, Peng J. Neoadjuvant savolitinib targeted therapy for stage IIIB-N3 lung adenocarcinoma harboring mesenchymal-epithelial transition exon 14 skipping mutation: a case report and literature review. Anticancer Drugs. 2024;35(5):445-449.
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