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同步双重原发性肺腺癌与EGFR和RET变异的连续向治疗:一个5年的随访病例报告

Yong-Liang Niu¹, Ying Yang², Xiao-Bao Teng¹

¹Department of Respiratory and Critical Care Medicine, No.2 People's Hospital of Fuyang City, Fuyang Infectious Disease Clinical College of Anhui Medical University, Fuyang, China.

Frontiers in oncology

|March 13, 2026

概括

从转移中区分多种原发性肺癌是关键. 这一案例显示了肺瘤的遗传差异,在耐药性发展后,指导向治疗和组合治疗.

科学领域:

在瘤学瘤学.
遗传学是一个遗传学.
肺部病理学肺部病理学

背景情况:

对多重肺结节的准确诊断对于有效治疗肺癌至关重要.
从肺内转移中区分多种原发性肺癌是一个诊断挑战.
内遗传异质性可以影响肺腺癌的治疗反应.

研究的目的:

报告双边多重原发性肺腺癌的病例,具有不同的遗传特征.
为了说明肺癌与内异质性的临床过程和治疗策略.
突出全面分子检测的重要性,以指导多焦点肺癌的精密治疗.

主要方法:

一个71岁的女性患者的病例报告,患有双边多重原发性肺腺癌.
单独的肺病变的综合分子测试,以确定遗传突变和融合.
连续治疗包括EGFR-TKI,化疗和RET抑制剂 (pralsetinib).
在获得耐药性后,随后使用pralsetinib和anlotinib进行联合治疗.

主要成果:

单独的肺病变含有不同的遗传变异:EGFR 19del突变和RET融合基因.
经EGFR-TKI和化疗的初始治疗后,pralsetinib的持续反应持续了三年多.
通过与pralsetinib和anlotinib的联合治疗,克服了对pralsetinib的耐药性的发展,实现了部分反应.
证明影响治疗选择和结果的门内基因异质性.

结论:

在多重肺病变中进行全面的分子分析对于指导多焦点肺癌的精确治疗至关重要.
向治疗,包括像普拉塞替尼这样的RET抑制剂,可以在RET融合阳性肺腺癌中有效.
组合疗法策略对于管理肺癌中对向药物的获得性耐药性至关重要.
这一案例为RET融合阳性肺癌的治疗和抗药后管理提供了宝贵的见解.

关键词:

在EGFR的突变.在RET的融合中,RET的融合.安洛丁尼布的使用方法双重原发性肺腺癌瘤.内异质性的异质性这种药物是pralsetinib.

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