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c-MET as a Potential Resistance Mechanism to Everolimus in Breast Cancer: From a Case Report to Patient Cohort
Valentin Van den Bossche1, Gaspard Jadot1, Guillaume Grisay1
1Medical Oncology Unit, Hopital de Jolimont, Rue Ferrer 159, 7100, Haine Saint Paul, Belgium.
Background:
We describe in a patient with breast cancer the change in c-MET expression during everolimus treatment, opening a better understanding of the resistance to everolimus and a role for cabozantinib.
Objective:
The objective of this study was to evaluate c-MET as a potential predictive biomarker for everolimus efficacy in breast cancer.
Methods:
We first selected a patient with breast cancer with a long-lasting response to everolimus and retrospectively profiled biopsies that were taken before everolimus initiation (Biopsy 1) and at progression on everolimus (Biopsy 2) using amplicon sequencing and immunohistochemistry. We then retrospectively evaluated c-MET expression in a cohort of patients with breast cancer treated with everolimus.
Results:
While not expressed in Biopsy 1, c-MET was highly expressed in Biopsy 2, suggesting a role for c-MET in breast cancer progression. Cabozantinib resulted in a rapid radiological response in this patient. Twenty-nine patients were included (12 c-MET-positive and 17 c-MET-negative patients) in the second part of the study. Baseline c-MET expression was associated with higher tumor grade, higher frequency of visceral metastases, and lower endocrine sensitivity. The c-MET-positive patients presented with a shorter progression-free survival (6.1 vs 10.5 months, respectively; p = 0.002) and a lower response rate (0% vs 12%) to everolimus, compared with c-MET-negative patients.
Conclusions:
c-MET could play a role in the resistance to everolimus and its inhibition should be evaluated in breast cancer.
Insights
Increased c-MET expression in breast cancer patients correlates with resistance to everolimus. Targeting c-MET with cabozantinib shows promise, suggesting c-MET as a predictive biomarker for everolimus efficacy.
Area of Science:
- Oncology
- Molecular Biology
- Translational Research
Background:
- Everolimus is a targeted therapy for breast cancer.
- Understanding resistance mechanisms is crucial for optimizing treatment.
- c-MET signaling is implicated in various cancers.
Observation:
- A patient with breast cancer developed high c-MET expression after progression on everolimus.
- This patient showed a significant response to cabozantinib, a c-MET inhibitor.
- In a cohort study, baseline c-MET positivity was linked to aggressive tumor features.
Findings:
- c-MET expression increased during everolimus treatment, indicating a role in resistance.
- c-MET-positive breast cancer patients had shorter progression-free survival and lower response rates to everolimus.
- Baseline c-MET expression was associated with higher tumor grade, visceral metastases, and lower endocrine sensitivity.
Implications:
- c-MET may serve as a predictive biomarker for everolimus efficacy in breast cancer.
- Inhibition of c-MET, potentially with cabozantinib, warrants further investigation in breast cancer treatment.
- This study opens avenues for personalized treatment strategies based on c-MET status.
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