Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2022; 10(8): 2529-2536
Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2529
Effective response to crizotinib of concurrent KIF5B-MET and MET-CDR2-rearranged non-small cell lung cancer: A case report
Lian-Fang Liu, Jia-Ying Deng, Analyn Lizaso, Jing Lin, Si Sun
Lian-Fang Liu, Department of Oncology, Zhangjiagang Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang 215600, Jiangsu Province, China
Jia-Ying Deng, Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Analyn Lizaso, Jing Lin, Burning Rock Biotech, Guangzhou 510300, Guangdong Province, China
Si Sun, Department of Medical Oncology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Author contributions: Liu LF and Deng JY contributed to the study concept and design and performed the statistical analysis; Liu LF, Deng JY, and Lin J contributed to the acquisition, analysis, and interpretation of the data; Liu L, Deng J, and Lizaso A contributed to the drafting of the manuscript; Sun S contributed to the critical revision of the manuscript for important intellectual content.
Supported by the National Key R&D Program of China, No. 2017YFC0907900 and 2017YFC0907904.
Informed consent statement: Written informed consent was obtained from the patient for publication of this manuscript and any accompanying images.
Conflict-of-interest statement: Lizaso A and Lin J were employees of Burning Rock Biotech during the conduct of the study. All other authors declare no competing interests.
CARE Checklist (2016) statement: The case was reported in accordance with the CARE reporting checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Si Sun, MD, Chief Doctor, Department of Medical Oncology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong An Road, Shanghai 200032, China. sunsi123sun@hotmail.com
Received: August 26, 2021
Peer-review started: August 26, 2021
First decision: October 29, 2021
Revised: November 12, 2021
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: March 16, 2022
Abstract
BACKGROUND

Due to the rarity of mesenchymal-epithelial transition factor (MET) fusions, the clinical efficacy of crizotinib has only been described in a few patients with MET fusions involving various fusion partners. Herein, we report the clinical response to crizotinib of a patient with advanced poorly differentiated non-small cell carcinoma (NSCLC) having concurrent MET fusions.

CASE SUMMARY

A 46-year-old woman was diagnosed with poorly differentiated NSCLC (T4N3M1). With no classic driver mutations, she was treated with two cycles of gemcitabine and cisplatin without clinical benefit. Targeted sequencing revealed the detection of two concurrent MET fusions, KIF5B-MET and novel MET-CDR2. Crizotinib was initiated at a dose of 250 mg twice daily. Within 4 wk of crizotinib therapy, repeat computed chromatography revealed a dramatic reduction in primary and metastatic lesions, assessed as partial response. She continued to benefit from crizotinib for 3 mo until disease progression and died within 1 mo despite receiving nivolumab therapy.

CONCLUSION

Crizotinib sensitivity was observed in an advanced poorly differentiated NSCLC patient with concurrent MET fusions KIF5B-MET and MET-CDR2. Crizotinib can serve as a therapeutic option for patients with MET fusions. In addition, our case also highlights the importance of comprehensive genomic profiling particularly in patients with no classic driver mutation for guiding alternative therapeutic decisions.

Keywords: Poorly differentiated, Non-small cell carcinoma, Mesenchymal-epithelial transition factor fusion, Crizotinib, Case report

Core Tip: The most common mesenchymal-epithelial transition factor (MET) gene aberrations are gene amplifications and exon 14 splice variants found in approximately 2% to 10% of lung cancer patients. Chromosomal rearrangements resulting in gene fusions involving MET are generally rare but could account for MET-driven oncogenesis. The rarity and diversity of MET fusions in non-small cell lung cancer (NSCLC) limit the volume of evidence documenting the clinical efficacy of crizotinib in treating MET-rearranged NSCLC patients. Herein, we report the clinical response to crizotinib of a patient with advanced poorly differentiated NSCLC harboring concurrent MET-involving rearrangements, including a novel MET-CDR2 gene fusion.