2. Academic Validation
  3. Acquired METD1228V Mutation and Resistance to MET Inhibition in Lung Cancer

Acquired METD1228V Mutation and Resistance to MET Inhibition in Lung Cancer

  • Cancer Discov. 2016 Dec;6(12):1334-1341. doi: 10.1158/2159-8290.CD-16-0686.
Magda Bahcall 1,  Taebo Sim 2 3,  Cloud P Paweletz 4,  Jyoti D Patel 5,  Ryan S Alden 1,  Yanan Kuang 4,  Adrian G Sacher 1,  Nam Doo Kim 6,  Christine A Lydon 1,  Mark M Awad 1 7,  Michael T Jaklitsch 8,  Lynette M Sholl 9,  Pasi A Jänne 10 4 7,  Geoffrey R Oxnard 10 7
Affiliations

Affiliations

  • 1 Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
  • 2 Chemical Kinomics Research Center, Korea Institute of Science and Technology, Seoul, Republic of Korea.
  • 3 KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, Republic of Korea.
  • 4 Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts.
  • 5 Department of Medicine, University of Chicago, Chicago, Illinois.
  • 6 Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Republic of Korea.
  • 7 Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
  • 8 Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
  • 9 Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
  • 10 Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. geoffrey_oxnard@dfci.harvard.edu pasi_janne@dfci.harvard.edu.
PMID: 27694386 DOI: 10.1158/2159-8290.CD-16-0686
Abstract

Amplified and/or mutated MET can act as both a primary oncogenic driver and as a promoter of tyrosine kinase inhibitor (TKI) resistance in non-small cell lung Cancer (NSCLC). However, the landscape of MET-specific targeting agents remains underdeveloped, and understanding of mechanisms of resistance to MET TKIs is limited. Here, we present a case of a patient with lung adenocarcinoma harboring both a mutation in EGFR and an amplification of MET, who after progression on erlotinib responded dramatically to combined MET and EGFR inhibition with savolitinib and osimertinib. When resistance developed to this combination, a new MET kinase domain mutation, D1228V, was detected. Our in vitro findings demonstrate that METD1228V induces resistance to type I MET TKIs through impaired drug binding, while sensitivity to type II MET TKIs is maintained. Based on these findings, the patient was treated with erlotinib combined with cabozantinib, a type II Met Inhibitor, and exhibited a response.

Significance: With several structurally distinct MET inhibitors undergoing development for treatment of NSCLC, it is critical to identify mechanism-based therapies for drug resistance. We demonstrate that an acquired METD1228V mutation mediates resistance to type I, but not type II, MET inhibitors, having therapeutic implications for the clinical use of sequential MET inhibitors. Cancer Discov; 6(12); 1334-41. ©2016 AACR.See related commentary by Trusolino, p. 1306This article is highlighted in the In This Issue feature, p. 1293.

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