Weng ZY, Huang WY, Shi BK, Pan JJ. Role of savolitinib in advanced gastric adenocarcinoma with meningeal carcinomatosis and cerebellar metastasis: A case report. World J Clin Cases 2024; 12(15): 2636-2641 [PMID: 38817213 DOI: 10.12998/wjcc.v12.i15.2636]
Corresponding Author of This Article
Zhi-Yun Weng, PhD, Chief Doctor, Department of Hematology, The Affiliated Yueqing Hospital of Wenzhou Medical University, No. 338 Qingyuan Road, Yueqing 325600, Zhejiang Province, China. weng_zhi_yun@163.com
Research Domain of This Article
Genetics & Heredity
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 26, 2024; 12(15): 2636-2641 Published online May 26, 2024. doi: 10.12998/wjcc.v12.i15.2636
Role of savolitinib in advanced gastric adenocarcinoma with meningeal carcinomatosis and cerebellar metastasis: A case report
Zhi-Yun Weng, Wen-Ye Huang, Bin-Kan Shi, Jian-Jia Pan
Zhi-Yun Weng, Wen-Ye Huang, Bin-Kan Shi, Jian-Jia Pan, Department of Hematology, The Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing 325600, Zhejiang Province, China
Co-first authors: Zhi-Yun Weng and Wen-Ye Huang.
Author contributions: Weng ZY provided direction and guidance throughout the preparation of this manuscript; Huang WY drafted the paper; Shi BK contributed to data analysis; Pan JJ made critical revisions related to important intellectual content of the manuscript; Weng ZY and Huang WY contributed equally to the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: Written consent was obtained from the patient’s family to participate in the study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE 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: Zhi-Yun Weng, PhD, Chief Doctor, Department of Hematology, The Affiliated Yueqing Hospital of Wenzhou Medical University, No. 338 Qingyuan Road, Yueqing 325600, Zhejiang Province, China. weng_zhi_yun@163.com
Received: January 30, 2024 Revised: February 14, 2024 Accepted: April 7, 2024 Published online: May 26, 2024
Abstract
BACKGROUND
Brain metastases (BM) are very rare in gastric adenocarcinoma (GaC), and patients with BMs have a higher mortality rate due to stronger tumor aggressiveness. However, its pathogenesis remains unclear. Genetic testing revealed cellular-mesenchymal epithelial transition factor receptor (MET) amplification. Therefore, treatment with savolitinib, a small molecule inhibitor of c-Met, was selected.
CASE SUMMARY
A 66-year-old woman was diagnosed with advanced GaC 6 months prior to presentation due to back pain. Cerebellar and meningeal metastases were observed during candonilimab combined with oxaliplatin and capecitabine therapy. The patient experienced frequent generalized seizures and persistent drowsiness in the emergency department. Genetic testing of cerebrospinal fluid and peripheral blood revealed increased MET amplification. After discussing treatment options with the patient, savolitinib tablets were administered. After a month of treatment, the intracranial lesions shrank considerably.
CONCLUSION
BM is very rare in advanced GaC, especially in meningeal cancer, that is characterized by rapid disease deterioration. There are very few effective treatment options available; however, technological breakthroughs in genomics have provided a basis for personalized treatment. Furthermore, MET amplification may be a key driver of BM in gastric cancer; however, this conclusion requires further investigation.
Core Tip: Common metastatic sites for gastric adenocarcinoma (GaC) occur in the lymph nodes, liver, and lungs. Additionally, brain metastases (BM) are rare. Interestingly, mesenchymal epithelial transition factor receptor (MET) amplification in GaC is rare, and its role in tumor metastasis remains unclear. Several previous reports have described the association between MET amplification and BM with GaC. This case highlights the unique phenomenon of rapid BM in advanced GaC after first-line treatment and the rapid short-term reduction of cerebellar metastases after the use of savolitinib. Therefore, it is hypothesized that MET amplification may be a key driver of BMs in GaC.
