Major partial response to crizotinib, a dual MET/ALK inhibitor, in a squamous cell lung (SCC) carcinoma patient with de novo c-MET amplification in the absence of ALK rearrangement

Lung Cancer. 2014 Jan;83(1):109-11. doi: 10.1016/j.lungcan.2013.10.006. Epub 2013 Oct 19.

Abstract

The initial radiotherapy of a 73 years old Caucasian male patient with advanced squamous cell lung carcinoma was terminated due to severe pericarditis. Subsequently, the tumor sample was analyzed for possible targets with comprehensive molecular diagnostics. EGFR, KRAS and PIK3CA genes were wild type, ALK and ROS1 were negative for rearrangement, but c-MET was amplified by fluorescent in situ hybridization. The kinase inhibitor crizotinib is already in clinical use for the treatment of ALK positive non-small cell lung cancers, but it is also known to be a potent c-MET inhibitor. The patient was treated with the standard dose of twice a day 250 mg crizotinib as a monotherapy. Major partial response to therapy was confirmed by chest CT and PET/CT after 8 weeks on therapy. C-MET expression is associated with poor prognosis and resistance to EGFR inhibitors. This case may indicate that c-MET tyrosine kinase inhibitors can be an effective targeted treatment option for squamous cell carcinoma patients, and future clinical trials should be expanded for this patient group as well.

Keywords: Crizotinib; Non-small cell lung cancer; Personalized medicine; Pharmacogenomics; Predictive biomarker; Receptor tyrosine kinase; Squamous cell lung cancer; Targeted therapy; c-MET.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anaplastic Lymphoma Kinase
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / genetics
  • Carcinoma, Squamous Cell / radiotherapy
  • Crizotinib
  • Gene Amplification
  • Gene Rearrangement / genetics
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / radiotherapy
  • Male
  • Mutation / genetics
  • Neoplasm Staging
  • Pericarditis / etiology
  • Protein Kinase Inhibitors / administration & dosage*
  • Proto-Oncogene Proteins c-met / genetics
  • Proto-Oncogene Proteins c-met / metabolism*
  • Pyrazoles / administration & dosage*
  • Pyridines / administration & dosage*
  • Radiography, Thoracic
  • Radiotherapy / adverse effects
  • Receptor Protein-Tyrosine Kinases / genetics
  • Tumor Burden / drug effects

Substances

  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyridines
  • Crizotinib
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Proto-Oncogene Proteins c-met
  • Receptor Protein-Tyrosine Kinases