case_images: PMC11250067_01
case_images: Tumor markers and thoracic computed tomography scans of Case 1 over MET TKI treatment. CEA, carcinoembryonic antigen; CK19, cytokeratin 19; NSE, neuron-specific enolase; TKI, tyrosine kinase inhibitors. Tepotinib therapy started in April 2022 and follow-up CT scan at 3-, 6-, 9-, 11-, 14- and 17-month suggested that lesions were stable.
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case_images: PMC11250067_01_fonc-14-1383964-g001.jpg
case_images: f1
case_images: Follow-up CT scan at 3-, 6-, 9-, 11-, 14- and 17-month suggested that lesions were stable ( Figure 1 ). Tumor marker neuron-specific enolase (NSE) showed a declining trend over treatment and carcinoembryonic antigen (CEA) and cytokeratin 19 (CK19) remained within the normal range ( Figure 1 ).
case_images: PMC11250067_02
case_images: Thoracic computed tomography scans of Case 2. (A). Diagnosis of metastatic NSCLC in March 2022 (B). Partial response with a significant decrease in size of left upper lobe lung mass at 6-month follow up in September 2022.
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case_images: f2
case_images: Three-, 6- and 9-month follow-up CT scan continuously showed partial response from the baseline scan ( Figure 2 ).
case_images: PMC11250067_03
case_images: PMC11250067_04
case_images: Liver function of Case 4 over MET TKI treatment. ALT, alanine transaminase; DBIL, direct bilirubin; TBIL, total bilirubin; TKI, tyrosine kinase inhibitors Liver function results immediately prior to savolitinib initiation are not available, and thus results from 9 May 2023 were taken as the reference liver function status before savolitinib therapy. Lines between 9 May 2023 and 14 June 2023 are thus displayed as dashed lines.
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case_images: PMC11250067_04_fonc-14-1383964-g003.jpg
case_images: f3
case_images: The patient was first treated by savolitinib (600mg, orally, once daily) at the local hospital starting from June 2023 for one month, during which he had significantly elevated level of alanine aminotransferase (ALT) of 2804U/L and increased total and direct bilirubin ( Figure 3 ), accompanied by rash, mouth ulcer and fever over the course. ALT, which dropped back to 25U/L ( Figure 3 ), the patient was initiated on tepotinib (450mg, orally, daily) in August 2023. A two-month follow-up liver function test in October 2023 suggested normal ALT and bilirubin levels ( Figure 3 ), and no adverse event was observed over the period.