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Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
Published on: August 11, 2017
Structural Alterations of MET Trigger Response to MET Kinase Inhibition in Lung Adenocarcinoma Patients
Dennis Plenker1,2, Miriam Bertrand3, Adrianus J de Langen4
1Molecular Pathology, Institute of Pathology, University of Cologne, Cologne, Germany.
Abstract:
Purpose: We sought to investigate the clinical response to MET inhibition in patients diagnosed with structural MET alterations and to characterize their functional relevance in cellular models.Experimental Design: Patients were selected for treatment with crizotinib upon results of hybrid capture-based next-generation sequencing. To confirm the clinical observations, we analyzed cellular models that express these MET kinase alterations.Results: Three individual patients were identified to harbor alterations within the MET receptor. Two patients showed genomic rearrangements, leading to a gene fusion of KIF5B or STARD3NL and MET One patient diagnosed with an EML4-ALK rearrangement developed a MET kinase domain duplication as a resistance mechanism to ceritinib. All 3 patients showed a partial response to crizotinib that effectively inhibits MET and ALK among other kinases. The results were further confirmed using orthogonal cellular models.Conclusions: Crizotinib leads to a clinical response in patients with MET rearrangements. Our functional analyses together with the clinical data suggest that these structural alterations may represent actionable targets in lung cancer patients. Clin Cancer Res; 24(6); 1337-43. ©2017 AACR.
Insights
Crizotinib shows clinical response in patients with MET rearrangements, including gene fusions. These MET alterations represent actionable targets in lung cancer, confirmed by cellular models.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Structural alterations in the MET receptor tyrosine kinase can drive cancer progression.
- Identifying actionable targets is crucial for effective lung cancer treatment.
Purpose of the Study:
- To investigate the clinical efficacy of MET inhibition in patients with structural MET alterations.
- To functionally characterize these MET alterations in cellular models.
Main Methods:
- Next-generation sequencing (NGS) for identifying MET alterations.
- Treatment of patients with crizotinib, a MET and ALK inhibitor.
- Analysis of cellular models expressing MET kinase alterations.
Main Results:
- Three patients with structural MET alterations were identified.
- Two patients had MET gene fusions (KIF5B-MET, STARD3NL-MET).
- All three patients showed partial response to crizotinib treatment.
Conclusions:
- Crizotinib demonstrates clinical activity in patients with MET rearrangements.
- Structural MET alterations are potential therapeutic targets in lung cancer.
- Functional validation in cellular models supports clinical findings.
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