Mesenchymal-epithelial transition Exon 14-Skipping Mutation-positive Invasive Mucinous Adenocarcinoma of the Lung: First Case Treated with Mesenchymal-epithelial Transition-tyrosine Kinase Inhibitors

Shinichi Okuzumi; Hiraku Suzuki; Shojiroh Morinaga; Masaki Tamura; Naoto Minematsu

doi:10.2169/internalmedicine.2540-23

Mesenchymal-epithelial transition Exon 14-Skipping Mutation-positive Invasive Mucinous Adenocarcinoma of the Lung: First Case Treated with Mesenchymal-epithelial Transition-tyrosine Kinase Inhibitors

Intern Med. 2023 Nov 13. doi: 10.2169/internalmedicine.2540-23. Online ahead of print.

Authors

Shinichi Okuzumi¹, Hiraku Suzuki¹, Shojiroh Morinaga², Masaki Tamura³, Naoto Minematsu¹

Affiliations

¹ Department of Medicine, Hino Municipal Hospital, Japan.
² Department of Diagnostic Pathology, Hino Municipal Hospital, Japan.
³ Department of Respiratory Medicine, Kyorin University, School of Medicine, Japan.

PMID: 37952955
DOI: 10.2169/internalmedicine.2540-23

Abstract

Mesenchymal-epithelial transition (MET) exon 14-skipping mutation (METex14) is rare in pulmonary invasive mucinous adenocarcinomas (IMAs), and the clinical impact of MET-tyrosine kinase inhibitors (TKIs) remains unknown. We herein report a 75-year-old woman with IMA harboring METex14 who was treated with the MET-TKI tepotinib. The lung tumor regressed over six months; however, the patient ultimately died of exacerbated interstitial lung disease (ILD), possibly associated with tepotinib. An autopsy revealed diffuse alveolar damage in preexisting chronic fibrosis. We discuss how to pre-evaluate ILD deterioration risks and monitor TKI-induced lung toxicity during treatment.

Keywords: MET exon 14 skipping mutation; interstitial lung disease; invasive mucinous adenocarcinoma; mesenchymal-epithelial transition factor; tepotinib; tyrosine kinase inhibitors.