Complete pathological response and negative postoperative ctDNA were not predictive of discontinuation of adjuvant crizotinib therapy in a patient with locally advanced MET ex14 skipping mutation-positive non-small cell lung cancer: a case report

Frontiers in Oncology

Oncology

Weiya Wang¹  Wenqing Yao¹  Zhenkun Liu²  Daxing Zhu²  Mingyu Fan²  Kaili Huang²  Jiantao Wang³ 

[1] Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China;Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China;Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China;Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China;Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China;Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China;

关键词: NSCLC;    MET exon 14 skipping mutation;    crizotinib rechallenge;    neoadjuvant targeted therapy;    case report;   

DOI  :  10.3389/fonc.2023.1164543

 received in 2023-02-13, accepted in 2023-07-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

Neoadjuvant targeted therapy is an alternative treatment for locally advanced non-small cell lung cancer (NSCLC) patients with driver gene mutation. MET ex14 mutation is considered a driver gene, and crizotinib is the first oral tyrosine kinase inhibitor (TKI) for metastatic MET ex14 mutation-positive NSCLC patients. Here, we reported a case of a locally advanced NSCLC patient harboring MET ex14 mutation who achieved pathological complete response following neoadjuvant crizotinib therapy but developed rapid metastasis due to discontinuation of short-term postoperative adjuvant crizotinib therapy. Although no driver gene mutation was found via next-generation sequencing (NGS) with blood samples before discontinuation of adjuvant crizotinib, the patient was given crizotinib rechallenge. Fortunately, the patient achieved durable complete response. This suggested that neither pathological complete response nor negative circulating tumor DNA (ctDNA) could be an effective predictor for discontinuation of adjuvant targeted therapy. This case report demonstrated the potential of crizotinib as neoadjuvant therapy in MET ex14 mutation-positive NSCLC patients as well as the importance of long-term postoperative therapy even with negative ctDNA in blood.

【 授权许可】

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Copyright © 2023 Wang, Yao, Wang, Fan, Huang, Liu and Zhu