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Published on: August 14, 2018
From knowledge to action: The journey toward targeting the MET pathway via MET exon 14 skipping
Wiktoria Bogdanska1, Paul K Paik2,3
1Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Abstract:
Targeted therapies have radically altered the prognosis of patients with non-small cell lung cancer (NSCLC). Although the MET pathway was characterized in 1984, the treatment paradigm for patients with MET alterations has only recently changed. Genomic alterations in MET are found in 3%-5% of patients with NSCLC, and can include MET exon 14 (METex14) skipping, MET-activating mutations, and MET amplification. These alterations lead to the prolonged activation of the cellular MET receptor and downstream proliferation pathways that drive cell survival and migration. This review explores the history and pathophysiology of the MET pathway by focusing on METex14 skipping, and highlights insights gained since its discovery. Both unsuccessful and successful treatments that have emerged alongside the evolution of next-generation sequencing are examined, as well as current approved therapies and future options that target potential resistance mechanisms.
Insights
Targeted therapies targeting MET alterations, including MET exon 14 skipping, have transformed non-small cell lung cancer (NSCLC) treatment. This review covers MET pathway history, pathophysiology, and evolving therapeutic strategies for NSCLC patients.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- The MET pathway, identified in 1984, plays a crucial role in cell survival and migration.
- Genomic alterations in MET, such as MET exon 14 (METex14) skipping, mutations, and amplification, occur in 3%-5% of non-small cell lung cancer (NSCLC) patients.
- These alterations lead to sustained MET receptor activation, driving tumor progression.
Purpose of the Study:
- To review the history and pathophysiology of the MET pathway, with a focus on METex14 skipping in NSCLC.
- To examine the evolution of diagnostic and therapeutic strategies for MET-altered NSCLC.
- To discuss current treatments and future directions for overcoming resistance mechanisms.
Main Methods:
- Literature review of the MET pathway, METex14 skipping, and targeted therapies in NSCLC.
- Analysis of historical and recent research on MET alterations and their clinical implications.
- Examination of treatment outcomes and resistance patterns associated with MET-targeted agents.
Main Results:
- MET alterations represent a significant driver in a subset of NSCLC patients.
- The development of next-generation sequencing has enabled the identification of these alterations.
- Targeted therapies have shown efficacy in patients with specific MET alterations, altering the treatment landscape.
Conclusions:
- METex14 skipping and other MET alterations are actionable targets in NSCLC.
- Advances in understanding the MET pathway have led to novel therapeutic options.
- Future research should focus on addressing resistance mechanisms to further improve patient outcomes.
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