PMC9360523_01
Next-generation sequencing detected MET fusion.
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An NGS test indicated that in addition to the coexistence of the EGFR L861Q/G719D double mutations, a novel acquired CUX1 (exon 14)-MET (exon 15) fusion was identified for the first time (Figure 1).
Immunohistochemical staining of MET showing positive in LADC biopsy specimens at 40x.
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An immunohistochemistry assay indicated strong expression for MET (Figure 2).
Computed tomographic (CT) images for the patient during the treatment course. (A) The patient experienced progressive disease during icotinib therapy (March 3, 2021). (B) The patient achieved PR following icotinib plus crizotinib therapy (June 7, 2021). (C) The patient achieved PR following icotinib plus crizotinib therapy (August 17, 2021). (D) The patient achieved SD following icotinib plus crizotinib therapy (December 2, 2021). Red arrows indicate the tumor.
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November 26, 2020 revealed disease stability. The patient again experienced disease progression on March 3, 2021 that included the presence of an enlarged lung lesion (74 mm x 78 mm), pleural thickening, and a small amount of pleural effusion (Figure 3A). NGS results, concurrent with EGFR double uncommon mutations and a CUX1-MET fusion, led us to a combined targeted strategy with icotinib (125 mg, TID) and crizotinib (250 mg, BID), inhibitors that targeted EGFR and MET, respectively, from March 3, 2021. On June 7, 2021, a CT scan revealed that the paramediastinal mass within the lung was significantly smaller (45 mm x 42 mm) than previously determined, and the patient reached PR (Figure 3B). To date, nine months have passed, and the patient is still at stable disease (SD) (Figures 3C, D).
A summary of the patient's treatment.
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Figure 4 provides a timeline that includes relevant care data.