Abstract

BackgroundSeveral c-MET targeting inhibitory molecules have already shown promising results in the treatment of patients with Non-small Cell Lung Cancer (NSCLC). Combination of EGFR- and c-MET-specific molecules may overcome EGFR tyrosine kinase inhibitor (TKI) resistance. The aim of this study was to allow for the identification of patients who might benefit from TKI treatments targeting MET and to narrow in on the diagnostic assessment of MET.Methods222 tumor tissues of patients with NSCLC were analyzed concerning c-MET expression and activation in terms of phosphorylation (Y1234/1235 and Y1349) using a microarray format employing immunohistochemistry (IHC). Furthermore, protein expression and MET activation was correlated with the amplification status by Fluorescence in Situ Hybridization (FISH).ResultsCorrelation was observed between phosphorylation of c-MET at Y1234/1235 and Y1349 (spearman correlation coefficient rs = 0.41; p < 0.0001). No significant correlation was shown between MET expression and phosphorylation (p > 0.05). c-MET gene amplification was detected in eight of 214 patients (3.7 %). No significant association was observed between c-MET amplification, c-MET protein expression and phosphorylation.ConclusionOur data indicate, that neither expression of c-MET nor the gene amplification status might be the best way to select patients for MET targeting therapies, since no correlation with the activation status of MET was observed. We propose to take into account analyzing the phosphorylation status of MET by IHC to select patients for MET targeting therapies. Signaling of the receptor and the activation of downstream molecules might be more crucial for the benefit of therapeutics targeting MET receptor tyrosine kinases than expression levels alone.

Highlights

  • Several c-Mesenchymal Epithelial Transition factor (MET) targeting inhibitory molecules have already shown promising results in the treatment of patients with Non-small Cell Lung Cancer (NSCLC)

  • MET protein expression evaluated by IHC in FFPE- versus Histology versus MET expression (HOPE) fixed NSCLC tissues We compared staining intensities of the MET specific antibody clone SP44 in formalin fixed paraffin embedded tissue versus HOPE-fixed tumor samples

  • When MET expression was evaluated in HOPE-fixed samples, staining intensities were mostly stronger compared to the appropriate FFPE tissue samples within one specimen (Fig. 1)

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Summary

Introduction

Several c-MET targeting inhibitory molecules have already shown promising results in the treatment of patients with Non-small Cell Lung Cancer (NSCLC). Combination of EGFR- and c-MET-specific molecules may overcome EGFR tyrosine kinase inhibitor (TKI) resistance. Increasing knowledge of expression patterns and molecular pathophysiology led to improved outcomes of patients with non-small cell lung cancer (NSCLC). Several MET-targeting inhibitors have already shown promising data in clinical trials [11,12,13]. Most of them are tyrosine kinase inhibitors followed by antagonistic antibodies [14, 15]. Spigel et al conducted a randomized phase II trial of onartuzumab in combination with erlotinib in patients with advanced NSCLC [18]. The onartuzumab/erlotinib combo did not show an overall survival benefit for the patients, even in the high expressers of MET [19]

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