case_images: PMC11365520_01
case_images: The patient's initial diagnosis and lesion changes after treatment. (A) CT result of initial diagnosis. (B) MET Y1003H mutation was found. (C) Lesions assessment after treatment.
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case_images: CT of the upper abdomen in our hospital showed consolidation of the lower lobe of the right lung (65*34 mm, Figure 1A) and right pleural effusion. The results showed the MET Y1003H [Variant allele frequency (VAF): 0.24%; Figure 1B], PIK3CA P539R (VAF: 0.02%), PMS2 cc.2006+2T>G (VAF: 0.08%), TP53 R248W (VAF: 0.53%) and Y205* (VAF: 0.06%) pathogenic mutations. After eight cycle's treatment, the tumor lesion in the right lung significantly decreased (from 65*34 mm to 8*6 mm, Figure 1C), so that the efficacy was assessed as partial response (PR) according to iRECIST criteria.
case_images: The mechanism of crizotinib resistance. (A) The lesion change after crizotinib resistance. (B) Genetic analysis showing D1228N point mutation.
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case_images: At the same time, chest CT showed irregular masses in the right lower lung (50*47 mm) with pleural effusion, diffuse nodular shadows in both lungs, with different sizes, solid and random distribution, and hilar lymph node enlargement (Figure 2A). TP53 R248W (VAF: 0.73%), and Y205* (VAF: 2.54%) mutations were detected (Figure 2B).