Molecular Profiling: Genomic-Guided Therapy for Lung Adenocarcinoma

Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases and is frequently diagnosed at advanced stages, leading to poor survival outcomes. Molecular analysis can identify actionable mutations, such as mesenchymal-epithelial transition (MET) exon 14 skipping mutations, which serve as therapeutic targets. Capmatinib, a selective MET tyrosine kinase inhibitor (TKI), has emerged as a promising targeted therapy for this molecular subtype. We present the case of an 83-year-old former smoker with a history of chronic obstructive pulmonary disease who was diagnosed with stage 4A metastatic lung adenocarcinoma. Molecular profiling revealed a MET exon 14 skipping mutation. The patient was initiated on capmatinib, resulting in sustained disease stability and a reduction in the lesion size over a three-year follow-up. This case highlights the clinical utility of molecular testing in NSCLC, particularly for identifying MET exon 14 alterations that guide targeted therapy. Capmatinib demonstrated durable disease control and was well tolerated, offering a viable alternative to conventional chemotherapy in an elderly patient with significant comorbidities. These findings support the integration of precision oncology into the management of advanced NSCLC and underscore the potential of MET TKIs to improve outcomes in this high-risk subgroup.