AUTHOR=Wang Jiantao , Yao Wenqing , Wang Weiya , Fan Mingyu , Huang Kaili , Liu Zhenkun , Zhu Daxing 

TITLE=Complete pathological response and negative postoperative ctDNA were not predictive of discontinuation of adjuvant crizotinib therapy in a patient with locally advanced MET ex14 skipping mutation-positive non-small cell lung cancer: a case report

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1164543

DOI=10.3389/fonc.2023.1164543

ISSN=2234-943X

ABSTRACT=Neoadjuvant targeted therapy is an alternative treatment for locally advanced NSCLC patients with driver gene mutation. MET ex14 mutation is considered as a driver gene and crizotinib was the first oral TKI for metastatic MET ex14 mutation positive NSCLC patients. Here we reported a case of locally advanced NSCLC patient harboring MET ex14 mutation who obtained pathological complete response followed neoadjuvant crizotinib therapy but developed rapid metastasis due to discontinuation of short-term postoperative adjuvant crizotinib therapy. Although no driver gene mutation was found via NGS with blood sample before discontinuation of adjuvant crizotinib, the patient was given crizotinib rechallenge, fortunately, the patient achieved durable complete response. It also suggested that neither pathological complete response nor negative ctDNA could be an effective predictor for discontinuation of adjuvant targeted therapy. This case report demonstrated the potential of crizotinib as neoadjuvant therapy in MET ex14 mutation positive NSCLC patients as well as the importance of long-term postoperative therapy even with negative ctDNA in blood.