Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real world

Abstract Background Mesenchymal to epithelial transition factor (MET) dysregulation in non-small-cell-lung-cancer (NSCLC) is understudied, with scant data on treatment outcomes. Methods We retrospectively examined 160 NSCLC patients: 125 with primary MET mutations (further classified into MET exon 1...

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Main Authors: Mengmeng Li, Jiuyan Huang, Ruyue Xing, Xinyang Du, Chunhua Wei, Huijuan Wang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-024-03437-4
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author Mengmeng Li
Jiuyan Huang
Ruyue Xing
Xinyang Du
Chunhua Wei
Huijuan Wang
author_facet Mengmeng Li
Jiuyan Huang
Ruyue Xing
Xinyang Du
Chunhua Wei
Huijuan Wang
author_sort Mengmeng Li
collection DOAJ
description Abstract Background Mesenchymal to epithelial transition factor (MET) dysregulation in non-small-cell-lung-cancer (NSCLC) is understudied, with scant data on treatment outcomes. Methods We retrospectively examined 160 NSCLC patients: 125 with primary MET mutations (further classified into MET exon 14 (METex14) skipping mutations and primary MET amplifications) and 35 with secondary MET amplifications. Patients underwent varied treatments: Chemotherapy, Immune monotherapy, Crizotinib, or Savolitinib. Secondary MET amplification patients were grouped by treatment: Group A (Class Ib MET-TKI with third-generation EGFR-TKI), Group B (Crizotinib with first-generation EGFR-TKI), and Group C (Crizotinib alone). One hundred and thirty patients have completed the whole treatment process. Their data were included in the study's survival analysis (included 95 patients with primary MET mutations and 35 patients with secondary MET amplifications). Results Among METex14 skipping mutations patients (n = 57), median progression free survival (PFS) was: Chemotherapy 7.64 m, Crizotinib 8.5 m, Savolitinib 9.3 m, and Immunotherapy 3.87 m. Targeted therapies and chemotherapy significantly outperformed Immunotherapy. Sub-group analysis indicated splice donor region mutations benefited more than those at the polypyrimidine tract (9.23 m vs. 4.03 m, P = 0.038). For primary MET amplifications (n = 38), PFS was: Chemotherapy 2.84 m, Crizotinib 3.80 m, Savolitinib 5.23 m, and Immunotherapy 3.30 m. Patients with copy number (CN) > 5 had longer PFS than CN ≤ 5 (5.17 m vs. 3.44 m, P = 0.039). In secondary MET amplifications (n = 35), Group A and B had similar PFS (6.77 m and 6.57 m) versus Group C (3.13 m). Dual-target therapy PFS showed no difference between CN ≤ 5 and CN > 5 (8.63 m vs. 6.27 m, P = 0.29). Conclusion NSCLC patients with METex14 skipping mutations benefit more from targeted therapies, especially those with splice donor mutations. MET amplification patients benefit universally from targeted therapies; primary MET amplifications show higher benefits with increased copy numbers. For secondary MET amplifications post-EGFR-TKI resistance, dual-target therapy surpasses Crizotinib monotherapy, independent of MET copy number.
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spelling doaj-art-2bb677e86c064b55869e16fa485e46a72025-01-26T12:13:08ZengBMCBMC Pulmonary Medicine1471-24662025-01-0125111110.1186/s12890-024-03437-4Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real worldMengmeng Li0Jiuyan Huang1Ruyue Xing2Xinyang Du3Chunhua Wei4Huijuan Wang5Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalDepartment of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalDepartment of Medical Oncology, Nanyang Central HospitalDepartment of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalDepartment of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalDepartment of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalAbstract Background Mesenchymal to epithelial transition factor (MET) dysregulation in non-small-cell-lung-cancer (NSCLC) is understudied, with scant data on treatment outcomes. Methods We retrospectively examined 160 NSCLC patients: 125 with primary MET mutations (further classified into MET exon 14 (METex14) skipping mutations and primary MET amplifications) and 35 with secondary MET amplifications. Patients underwent varied treatments: Chemotherapy, Immune monotherapy, Crizotinib, or Savolitinib. Secondary MET amplification patients were grouped by treatment: Group A (Class Ib MET-TKI with third-generation EGFR-TKI), Group B (Crizotinib with first-generation EGFR-TKI), and Group C (Crizotinib alone). One hundred and thirty patients have completed the whole treatment process. Their data were included in the study's survival analysis (included 95 patients with primary MET mutations and 35 patients with secondary MET amplifications). Results Among METex14 skipping mutations patients (n = 57), median progression free survival (PFS) was: Chemotherapy 7.64 m, Crizotinib 8.5 m, Savolitinib 9.3 m, and Immunotherapy 3.87 m. Targeted therapies and chemotherapy significantly outperformed Immunotherapy. Sub-group analysis indicated splice donor region mutations benefited more than those at the polypyrimidine tract (9.23 m vs. 4.03 m, P = 0.038). For primary MET amplifications (n = 38), PFS was: Chemotherapy 2.84 m, Crizotinib 3.80 m, Savolitinib 5.23 m, and Immunotherapy 3.30 m. Patients with copy number (CN) > 5 had longer PFS than CN ≤ 5 (5.17 m vs. 3.44 m, P = 0.039). In secondary MET amplifications (n = 35), Group A and B had similar PFS (6.77 m and 6.57 m) versus Group C (3.13 m). Dual-target therapy PFS showed no difference between CN ≤ 5 and CN > 5 (8.63 m vs. 6.27 m, P = 0.29). Conclusion NSCLC patients with METex14 skipping mutations benefit more from targeted therapies, especially those with splice donor mutations. MET amplification patients benefit universally from targeted therapies; primary MET amplifications show higher benefits with increased copy numbers. For secondary MET amplifications post-EGFR-TKI resistance, dual-target therapy surpasses Crizotinib monotherapy, independent of MET copy number.https://doi.org/10.1186/s12890-024-03437-4Mesenchymal-epithelial transition factorNon-small cell lung cancerCrizotinibSavolitinib
spellingShingle Mengmeng Li
Jiuyan Huang
Ruyue Xing
Xinyang Du
Chunhua Wei
Huijuan Wang
Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real world
BMC Pulmonary Medicine
Mesenchymal-epithelial transition factor
Non-small cell lung cancer
Crizotinib
Savolitinib
title Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real world
title_full Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real world
title_fullStr Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real world
title_full_unstemmed Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real world
title_short Exploring practical experience with different treatments in NSCLC patients with MET-deregulated: a retrospective analysis from the real world
title_sort exploring practical experience with different treatments in nsclc patients with met deregulated a retrospective analysis from the real world
topic Mesenchymal-epithelial transition factor
Non-small cell lung cancer
Crizotinib
Savolitinib
url https://doi.org/10.1186/s12890-024-03437-4
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