PMC8077408_01
Results of the molecular pathological analysis. Upper panels: IGV (Integrative Genomics Viewer) displays of the detected EGFR mutations (referred to refseq ID NM_005228); left: exon 19 deletion EGFR:p.E746_A750delELREA with a frequency of 68%; right: point mutation EGFR:p.T790M with a frequency of 29%. Lower panels: detection of the MET amplification; left: CNV analysis based on the coverage of the next-generation sequencing data; right: representative image of chromogenic in situ hybridization with a nucleic signal for the centromeric region of chromosome 7 (CEP7; red) and the MET gene locus (green). An evaluation of more than 20 tumor cells in two distinct regions of the tumor showed a clear increase in MET signals with a clustered pattern and a MET/CEP7 ratio of 6.9.
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F1
Confirmatory chromogenic in situ hybridization showed a clear increase in the MET signal with a clustered pattern (Fig. 1) and a 6.9 MET/CEP7 (centromeric probe of chromosome 7) ratio.
Schematic summary of the combined treatment and the clinical course.
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F2
A CT scan after 4 weeks showed an impressive response with a complete resolution of the left lung nodules (Fig. 2). Repeat CT scanning after 2 months showed a PR on both lungs (Fig. 2).