Targeting MET and KRAS G12C co-occurring mutation in metastatic adenoid cystic carcinoma of the trachea: a case report.

BACKGROUND

MET and KRAS comutation in the same group of cells of primary tracheal adenoid cystic carcinoma is extremely rare; there is no standard of care for patient with metastatic disease.

CASE PRESENTATION: We report a 42-year-old treatment-naïve Chinese male patient with metastatic tracheal adenoid cystic carcinoma harboring a MET p.D1010Y and KRAS p.G12C comutation. The patient responded well to the MET inhibitor crizotinib and MEK inhibitor trametinib combination therapy, but had progression when he discontinued trametinib because of grade III rashes on the face and trunk. With the reintroduction of trametinib with a dose reduction, his metastatic lesions shrank after 2 months of therapy.

CONCLUSION

MET p.D1010Y and KRAS p.G12C comutation is extremely rare and could happen concurrently in the same group of cells of metastatic tracheal adenoid cystic carcinoma; crizotinib combined with trametinib is effective, and the toxicities are manageable.