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Sun Z, Xia B, Zhang M, Xu S, Ma Y, Zhang X. Case report: Prompt response to radiotherapy and chemotherapy combined with crizotinib in gingival sarcomatoid squamous cell carcinoma with MET 14 mutation. Front Oncol 2022; 12:1006516. [PMID: 36147925 PMCID: PMC9486213 DOI: 10.3389/fonc.2022.1006516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAs a kind of squamous cell carcinoma of head and neck (HNSCC), gingival sarcomatoid squamous cell carcinoma (GSSCC) is a rare biphasic malignant neoplasm. To date, surgical resection was often utilized for gingival squamous cell carcinoma (GSCC), while for patients with advanced gingival carcinoma who cannot tolerate surgery, radiotherapy and chemotherapy can be regarded as a treatment strategy. Many molecular-targeted drugs were investigated and approved for the treatment of malignant diseases, including hematologic diseases and solid tumors. Although targeted therapies such as EGFR inhibitors have shown therapeutic efficacy in HNSCC, there are still some patients who cannot benefit from it. New therapeutic targets and strategies should be further explored.Case presentationAn 83-year-old woman was referred to our hospital with left lower gingival mass for more than 1 month in June 2021. Pathologic diagnosis is sarcomatoid squamous cell carcinoma. Due to the large tumor at the time of diagnosis and poor quality of life, the patient was intolerant to surgery, so she was given radiotherapy (RT) combined with concurrent chemotherapy (CT) with albumin bound paclitaxel. According to next-generation sequencing (NGS) results (MET exon 14 skipping mutation-positive), she was treated with crizotinib, a tyrosine kinase inhibitor that targets MET. Through the comprehensive treatment, the patient’s condition promptly improved, clinical complete remission (CR) was achieved in 2 months, and 9-month progression-free survival (PFS) was obtained. She finally died from non-cancer-related diseases.ConclusionHere we report the treatment of a GSSCC patient with MET mutation, who responded to crizotinib promptly and positively. It provides a new reference for understanding MET abnormalities in GSSCC and offers a new idea for the targeted treatment of gingival carcinoma.
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Affiliation(s)
- Zhenhua Sun
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of North China University of Science and Technology, Tangshan, China
| | - Bingjie Xia
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of Hebei North University, Zhangjiakou, China
| | - Ming Zhang
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- *Correspondence: Ming Zhang,
| | - Shuai Xu
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
- Graduate School of Hebei North University, Zhangjiakou, China
| | - Yingqian Ma
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
| | - Xianbo Zhang
- Department of Radiation Oncology, Hebei General Hospital, Shijiazhuang, China
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Lee JK, Madison R, Classon A, Gjoerup O, Rosenzweig M, Frampton GM, Alexander BM, Oxnard GR, Venstrom JM, Awad MM, Schrock AB. Characterization of Non-Small-Cell Lung Cancers With MET Exon 14 Skipping Alterations Detected in Tissue or Liquid: Clinicogenomics and Real-World Treatment Patterns. JCO Precis Oncol 2021; 5:PO.21.00122. [PMID: 34476332 PMCID: PMC8407654 DOI: 10.1200/po.21.00122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/01/2021] [Accepted: 06/30/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE MET exon 14 (METex14) skipping alterations are oncogenic drivers in non–small-cell lung cancer (NSCLC). We present a comprehensive overview of METex14 samples from 1,592 patients with NSCLC, associated clinicogenomic characteristics, potential mechanisms of acquired resistance, treatment patterns, and outcomes to MET inhibitors. METHODS Hybrid capture–based comprehensive genomic profiling (CGP) was performed on samples from 69,219 patients with NSCLC. For treatment patterns and outcomes analysis, patients with advanced METex14-altered NSCLC were selected from the Flatiron Health-Foundation Medicine clinicogenomic database, a nationwide deidentified electronic health record–derived database linked to Foundation Medicine CGP for patients treated between January 2011 and March 2020. RESULTS A total of 1,592 patients with NSCLC (2.3%) were identified with 1,599 METex14 alterations spanning multiple functional sites (1,458 of 60,244 tissue samples and 134 of 8,975 liquid samples). Low tumor mutational burden and high programmed death ligand 1 expression were enriched in METex14-altered samples. MDM2, CDK4, and MET coamplifications and TP53 mutations were present in 34%, 19%, 11%, and 42% of tissue samples, respectively. Comparing tissue and liquid cohorts, coalteration frequency and acquired resistance mechanisms, including multiple MET mutations, EGFR, ERBB2, KRAS, and PI3K pathway alterations, were generally similar. Positive percent agreement with the tissue was 100% for METex14 pairs collected within 1 year (n = 7). Treatment patterns showed increasing adoption of MET inhibitors in METex14-altered NSCLC after receipt of CGP results; the real-world response rate to MET inhibitors was 45%, and time to treatment discontinuation was 4.4 months. CONCLUSION Diverse METex14 alterations were present in 2%-3% of NSCLC cases. Tissue and liquid comparisons showed high concordance and similar coalteration profiles. Characterizing common co-occurring alterations and immunotherapy biomarkers, including those present before or acquired after treatment, may be critical for predicting responses to MET inhibitors and informing rational combination strategies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Mark M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
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Lüttich L, Besso MJ, Heiden S, Koi L, Baumann M, Krause M, Dubrovska A, Linge A, Kurth I, Peitzsch C. Tyrosine Kinase c-MET as Therapeutic Target for Radiosensitization of Head and Neck Squamous Cell Carcinomas. Cancers (Basel) 2021; 13:1865. [PMID: 33919702 PMCID: PMC8070694 DOI: 10.3390/cancers13081865] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/26/2021] [Accepted: 04/11/2021] [Indexed: 11/23/2022] Open
Abstract
The receptor tyrosine kinase c-MET activates intracellular signaling and induces cell proliferation, epithelial-to-mesenchymal-transition and migration. Within the present study, we validated the prognostic value of c-MET in patients with head and neck squamous cell carcinoma (HNSCC) treated with radio(chemo)therapy using the Cancer Genome Atlas database and found an association of increased MET gene expression and protein phosphorylation with reduced disease-specific and progression-free survival. To investigate the role of c-MET-dependent radioresistance, c-MET-positive cells were purified from established HNSCC cell lines and a reduced radiosensitivity and enhanced sphere-forming potential, compared to the c-MET-depleted cell population, was found in two out of four analyzed cell lines pointing to regulatory heterogeneity. We showed that c-MET is dynamically regulated after irradiation in vitro and in vivo. Interestingly, no direct impact of c-MET on DNA damage repair was found. The therapeutic potential of eight c-MET targeting agents in combination with irradiation demonstrated variable response rates in six HNSCC cell lines. Amongst them, crizotinib, foretinib, and Pha665752 exhibited the strongest radiosensitizing effect. Kinase activity profiling showed an association of crizotinib resistance with compensatory PI3K/AKT and MAP kinase signaling. Overall, our results indicate that c-MET is conferring radioresistance in HNSCC through modulation of intracellular kinase signaling and stem-like features.
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Affiliation(s)
- Lina Lüttich
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
| | - María José Besso
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (M.J.B.); (I.K.)
| | - Stephan Heiden
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
| | - Lydia Koi
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiooncology–OncoRay, 01307 Dresden, Germany
| | - Michael Baumann
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (M.J.B.); (I.K.)
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- German Cancer Consortium (DKTK) Core Center Heidelberg, 69120 Heidelberg, Germany
| | - Mechthild Krause
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (M.J.B.); (I.K.)
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiooncology–OncoRay, 01307 Dresden, Germany
- National Center for Tumor Diseases (NCT), 01307 Dresden, Germany
- German Cancer Consortium (DKTK) Partner Site Dresden, 01307 Dresden, Germany
| | - Anna Dubrovska
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (M.J.B.); (I.K.)
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiooncology–OncoRay, 01307 Dresden, Germany
- National Center for Tumor Diseases (NCT), 01307 Dresden, Germany
- German Cancer Consortium (DKTK) Partner Site Dresden, 01307 Dresden, Germany
| | - Annett Linge
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (M.J.B.); (I.K.)
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- National Center for Tumor Diseases (NCT), 01307 Dresden, Germany
- German Cancer Consortium (DKTK) Partner Site Dresden, 01307 Dresden, Germany
| | - Ina Kurth
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (M.J.B.); (I.K.)
| | - Claudia Peitzsch
- OncoRay—National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden—Rossendorf, 01307 Dresden, Germany; (L.L.); (S.H.); (L.K.); (M.B.); (M.K.); (A.D.); (A.L.)
- National Center for Tumor Diseases (NCT), 01307 Dresden, Germany
- German Cancer Consortium (DKTK) Partner Site Dresden, 01307 Dresden, Germany
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