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Case Reports
. 2024 May 26;12(15):2636-2641.
doi: 10.12998/wjcc.v12.i15.2636.

Role of savolitinib in advanced gastric adenocarcinoma with meningeal carcinomatosis and cerebellar metastasis: A case report

Zhi-Yun Weng  1 , Wen-Ye Huang  2 , Bin-Kan Shi  2 , Jian-Jia Pan  2
Affiliations
Case Reports

Role of savolitinib in advanced gastric adenocarcinoma with meningeal carcinomatosis and cerebellar metastasis: A case report

Zhi-Yun Weng et al. World J Clin Cases. .

Abstract

Background: Brain metastases (BM) are very rare in gastric adenocarcinoma (GaC), and patients with BMs have a higher mortality rate due to stronger tumor aggressiveness. However, its pathogenesis remains unclear. Genetic testing revealed cellular-mesenchymal epithelial transition factor receptor (MET) amplification. Therefore, treatment with savolitinib, a small molecule inhibitor of c-Met, was selected.

Case summary: A 66-year-old woman was diagnosed with advanced GaC 6 months prior to presentation due to back pain. Cerebellar and meningeal metastases were observed during candonilimab combined with oxaliplatin and capecitabine therapy. The patient experienced frequent generalized seizures and persistent drowsiness in the emergency department. Genetic testing of cerebrospinal fluid and peripheral blood revealed increased MET amplification. After discussing treatment options with the patient, savolitinib tablets were administered. After a month of treatment, the intracranial lesions shrank considerably.

Conclusion: BM is very rare in advanced GaC, especially in meningeal cancer, that is characterized by rapid disease deterioration. There are very few effective treatment options available; however, technological breakthroughs in genomics have provided a basis for personalized treatment. Furthermore, MET amplification may be a key driver of BM in gastric cancer; however, this conclusion requires further investigation.

Keywords: Case report; Cellular-mesenchymal epithelial transition factor receptor; Gastric adenocarcinoma; Meningeal carcinomatosis; Savolitinib.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Enhanced magnetic resonance imaging image of a patient with brain metastasis undergoing savolitinib treatment. A: Fluid attenuated inversion recovery image (November 11, 2023); B: T1 image (November 11, 2023); C: T2 image (November 11, 2023); D: Sagittal view of T2 image (November 11, 2023); E: Fluid attenuated inversion recovery image (December 26, 2023); F: T1 image (December 26, 2023); G: T2 image (December 26, 2023); H: Sagittal view of T2 image (December 26, 2023). Orange arrow shows the tumor.
See this image and copyright information in PMC

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