medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-244medsovet-8407Research ArticleПРАКТИКАPRACTICEРак легкого, ассоциированный с активирующей мутацией в 14-м экзоне гена METLung cancer associated with an activating mutation in the 14th exon of the MET genehttps://orcid.org/0000-0003-0181-2919КузьминаВ. А.KuzminaV. A.

Кузьмина Валерия Александровна - аспирант отделения противоопухолевой лекарственной терапии №3 отдела лекарственного лечения.

115478, Москва, Каширское шоссе, д. 24

Valeriya A. Kuzmina - Postgraduate Student, Cancer Drug Therapy (Chemotherapeutic) Department No. 3.

24, Kashirskoye Shosse, Moscow, 115478

emerallld@yandex.ruhttps://orcid.org/0000-0002-2154-3376РеутоваЕ. В.ReutovaE. V.

Реутова Елена Валерьевна - к.м.н., старший научный сотрудник отделения противоопухолевой лекарственной терапии №3 отдела лекарственного лечения.

115478, Москва, Каширское шоссе, д. 24

Elena V. Reutova - Cand. Sci. (Med.), Senior Research Associate of Cancer Drug Therapy Department No. 3.

24, Kashirskoye Shosse, Moscow, 115478

ereutova@rambler.ruhttps://orcid.org/0000-0003-4469-502XЛактионовК. К.LaktionovK. K.

Лактионов Константин Константинович, д.м.н., заведующий отделением противоопухолевой лекарственной терапии №3 отдела лекарственного лечения, НМИЦ имени Н.Н. Блохина; профессор кафедры онкологии и лучевой терапии лечебного факультета; РНИМУ имени Н.И. Пирогова;

115478, Москва, Каширское шоссе, д. 24; 117997, Москва, ул. Островитянова, д. 1

Konstantin K. Laktionov - Dr. Sci. (Med.), Head of Cancer Drug Therapy Department No. 3, Blokhin NMRCOn; Professor, Department of Oncology and X-ray Therapy, General Medicine Faculty, Pirogov RNRMU.

24, Kashirskoye Shosse, Moscow, 115478; 1, Ostrovityanov St., Moscow, 117997

lkoskos@mail.ruhttps://orcid.org/0000-0002-8967-7987АрдзинбаМ. С.ArdzinbaM. A.

Ардзинба Мераб Сергеевич - к.м.н., научный сотрудник отделения противоопухолевой лекарственной терапии №3 отдела лекарственного лечения.

115478, Москва, Каширское шоссе, д. 24

Merab A. Ardzinba - Cand. Sci. (Med.), Research Associate of Cancer Drug Therapy Department No. 3.

24, Kashirskoye Shosse, Moscow, 115478

merabii@mail.ruНациональный медицинский исследовательский центр онкологии имени Н.Н. БлохинаРоссияBlokhin National Medical Research Center of OncologyRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Блохина; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияBlokhin National Medical Research Center of Oncology; Pirogov Russian National Research Medical UniversityRussian Federation202425072024010153160Copyright © Кузьмина В.А., Реутова Е.В., Лактионов К.К., Ардзинба М.С., 20242024Кузьмина В.А., Реутова Е.В., Лактионов К.К., Ардзинба М.С.Kuzmina V.A., Reutova E.V., Laktionov K.K., Ardzinba M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8407

В последние годы продолжается активный поиск и разработка новых терапевтических мишеней в отношении прогностически неблагоприятной группы пациентов с диссеминированным немелкоклеточным раком легкого (НМРЛ). Исследования показали, что возникновение рака легкого может быть связано с первичной мутацией драйверных генов, таких как EGFR, ALK, ROS1, BRAF, KRAS, RET, MET, HER2, NTRK1/2/3 и т.д., в норме отвечающих за физиологические процессы роста, пролиферации, дифференцировки. Открытие таргетных препаратов с высокой активностью в отношении некоторых мутаций привело к изменению парадигмы терапевтических подходов и улучшению прогноза у тщательно отобранной категории больных. Наличие активирующей мутации предопределяет клинико-морфологический портрет пациента. Одна из таких мутаций – мутация МЕТ с пропуском 14-го экзона (METex14 skipping mutation), выявляется, как правило, у пациентов старшей возрастной группы с диссеминированным опухолевым процессом, более агрессивным течением болезни и неудовлетворительным прогнозом при применении только стандартной химиотерапии. Представленный клинический случай демонстрирует возможность длительного контроля над заболеванием при сохранении удовлетворительного качества жизни у пожилой пациентки с НМРЛ, ассоциированным с мутацией METex14, а также подчеркивает важную роль и ценность метода секвенирования следующего поколения для персонализации терапии и получения новых сведений о потенциальных мишенях и эффективных молекул к ним в будущем.

In recent years, the active search and development of new therapeutic agents for a prognostically unfavourable group of patients with disseminated non-small cell lung cancer (NSCLC) has continued. Studies show that the occurrence of lung cancer can be associated with mutations of driver genes such as EGFR, ALK, ROS1, BRAF, KRAS, RET, MET, HER2, NTRK1/2/3, etc., in the normal processes of growth, proliferation, differentiation. The discovery of targeting drugs with high activity against certain mutations has led to a paradigm opening of therapeutic approaches and continued prognosis in serious disease. The presence of activating mutations predetermines the clinical and morphological profile of the patient. One of the random mutations – MET mutation with exon 14 skipping (METex14) is observed, as a rule, in patients of older age group, with disseminated tumour process, more aggressive course of the disease and poor prognosis with chemotherapy alone. This case provides an opportunity for long-term disease control while maintaining satisfactory quality of life in an elderly patient with NSCLC associated with METex14 mutations, as well as providing a major role and method for obtaining next-generation value for personalisation of therapy and new insights into the scientific targets and the future use of molecules to them.

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The authors declare that there are no conflicts of interest present.